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Xu Z.W.,Shanghai Childrens Medical Center | Shen J.,Shanghai JiaoTong University
Journal of Cardiac Surgery | Year: 2010

Objective: To find a better method of right ventricular-pulmonary artery (RV-PA) reconstruction in repairing truncus arteriosus (TA). Basic studies design: Retrospective clinical study, contrast study. Clinical setting: Shanghai Children's Medical Center. Participants: 23 patients with truncus arteriosus. Intervention: To decrease the man-made interference, all of the exams during the follow-up period were carried out at our center. Main outcome measurements: Hospital death, survival rate, the later outcomes during follow-up including the growth of pulmonary artery, the later heart function, and reintervention. Results: There were two early hospital deaths, with no deaths during follow-up. The overall survival rate was 91.30%. One patient underwent reintervention for RVOTO. In Group 1, the difference between the diameters of RV-PA anastomosis was statistically significant. The early diameter was 1.01 ± 0.26 cm, the later was 1.32 ± 0.45 cm, p = 0.019. The velocity of flow at the position of anastomosis and the orifice of RPA/LPA was acceptable. There was a significant difference between the growth ratio of the RV-PA anastomosis of two groups, with a p value of 0.048. The later ejection fraction was higher than the early one in both groups. There was no reintervention for truncal valve regurgitation. Conclusions: The postoperative survival and follow-up results were satisfactory. A direct anastomosis of RV-PA continuity has the potential for RVOT growth and is associated with a low ratio of pulmonary artery and bifurcation obstruction. The myocardial function improved during follow-up period. IAA was a major risk factor associated with hospital death. © 2010 Wiley Periodicals, Inc.

Deng Z.H.,Shanghai Childrens Medical Center
Zhonghua er ke za zhi. Chinese journal of pediatrics | Year: 2012

To explore an innovative technique that is aided by multi-disciplinary hybrid approach in identification and treatment of tracheoesophageal fistula (TEF) in children intraoperatively. From April 2008 to October 2011, 4 patients with isolated TEF were presented with 2 H-type fistulas and 2 recurrent TEF. For all the four cases, with the cooperation of the gastroenterologists, respiratory physician and surgeon, methylene blue was first injected into the trachea for detecting the dye in the esophagus by the gastroscopy. Bronchoscopy was performed where the fistula tract was shown by the methylene blue and a guide wire was passed through the fistula. The patients underwent rigid gastroscopy and the guide wire was identified and brought out through the mouth by biopsy pliers. This created a wire loop through the fistula. X-ray was then used to identify the level of the fistula. According to the level of the fistula it was determined whether surgical incision and approach should be used. The fistula was then repaired successfully by surgery. In the 4 patients, with the aid of gastroscopy and bronchoscopy, identification of the fistula intraoperatively was then facilitated by traction on the loop. The fistula was identified and repaired. There were no fistula recurrences. Multi-disciplinary hybrid therapy for tracheoesophageal fistula in children is beneficial for the precise localization of the fistula. This new technique is an effective and definitive method in identification and treatment of TEF in children.

Sun J.,Shanghai Childrens Medical Center | Zhong L.,Shanghai First Peoples Hospital | Zhu Y.,Shanghai First Peoples Hospital | Liu G.,Shanghai First Peoples Hospital
Journal of Reproduction and Development | Year: 2011

The aim of this study was to establish a novel method for isolating and purifying Leydig cells from mice testes. Testes of postpuberal mice were harvested and digested in a low concentration of collagenase NB4 for 15 min 2 times. Cells obtained were cultured in low glucose DMEM with 10% FBS. Immunofluorescence was used to detect the expression of Leydig cell biomarkers including 3β-hydroxysteroid dehydrogenase, cholesterol side-chain cleaving enzyme (CYP11A1) and 17α-hydroxylase/17,20-lyase (CYP17A1). It was found that the purity of the isolated Leydig cells was 69.6 ± 4.16%. After 7 days in primary culture, it increased to 90%. The testosterone synthase spectrum could be detected at the primary culture. In conclusion, the application of a low concentration of collagenase for differential digestion allows isolation of large quantities of viable Leydig cells. © 2011 by the Society for Reproduction and Development.

Hu C.-E.,Fudan University | Liu Y.-C.,Fudan University | Zhang H.-D.,Shanghai Childrens Medical Center | Huang G.-J.,Fudan University
Biochemical and Biophysical Research Communications | Year: 2014

A number of JmjC domain-containing histone demethylases have been identified and biochemically characterized in mammalian. JMJD2A is a transcriptional cofactor and enzyme that catalyzes demethylation of histone H3 lysines 9 and 36. Here in this study, we aim to explore the role of JMJD2A in human gastric cancer. Quantitative real-time PCR, Western blot and immunohistochemistry analyses reveal higher expression of JMJD2A in clinical gastric cancer tissues than that in normal gastric mucosa. JMJD2A expression is associated with tumor stage and nodal status, and high level of JMJD2A predicts poor overall and disease-free survival. Univariate and multivariate survival analyses demonstrate that JMJD2A could serve as an independent prognostic factor. Furthermore, we show that inhibition the expression of JMJD2A attenuates the growth and transformation of three lines of gastric cancer cells. Mechanically, JMJD2A knockdown induces apoptosis of gastric cancer cells by up-regulating the expression of pro-apoptotic proteins and by down-regulating anti-apoptotic protein. Finally, we show that JMJD2A level is correlated with the level of the pro-apoptotic microRNA miR-34a in gastric cancer tissues and JMJD2A represses the expression of miR-34a by decreasing its promoter activity. Those findings demonstrate that JMJD2A regulates gastric cancer growth and serves as an independent prognostic factor, and implicate that JMJD2A may be a promising target for intervention. © 2014 Elsevier Inc. All rights reserved.

Cheng X.,Anhui Medical University | Huang Y.,Shanghai Childrens Medical Center | Zhao Q.,Anhui Medical University | Gu E.,Anhui Medical University
Journal of Anaesthesiology Clinical Pharmacology | Year: 2014

Background: Children with obstructive sleep apnea (OSA) are particularly at risk under anesthesia after uvulopalatopharyngoplasty (UPPP). This prospective randomized double-blind study focused on the comparison of dexmedetomidine- ketamine and sevoflurane-sufentanil anesthesia on children with respect to safety, feasibility, and clinical effects. Materials and Methods: A total of 60 children, aged 2-10 years, classified as American Society of Anesthesiologists (ASA) status I and II scheduled for UPPP were prospectively studied. Patients were randomly allocated to receive either dexmedetomidine-ketamine-based anesthesia (group DK, n = 30) or sevoflurane-sufentanil-based anesthesia (group SS, n = 3 0). Heart rate (HR) and systolic blood pressure during the first 60 min of the procedure, Ramsay sedation score, the Pediatric Anesthesia Emergence Delirium (PAED) scale and a 5-point scale used to evaluate emergence agitation (EA) in postanesthesia care unit (PACU) and postoperative outcomes data were recorded. Results: During the first 60 min of anesthesia, mean HR, and mean diastolic noninvasive arterial blood pressure (NIBP) were not statistically different in the two groups (P > 0.05) Compared with group SS, the patients in group DK had lower rescue tramadol requirement and lower pain score, PAED score, and EA score at 5, 10, 15, and 30 min in PACU; but had a higher Ramsay scale at 10, 15, 30, 45, and 60 min in PACU and the incidence of SpO 2 below 95%, also the time of first bowel movement and ambulation in group DK was shorter. Conclusions: The dexmedetomidine-ketamine combination was not superior to a sevoflurane-sufentanil combination because of late awake time and a high potential for adverse respiratory events in PACU, the benefit of dexmedetomidine administration being a decreased incidence of EA and a lower recovery time of bowel movement and ambulation.

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