OBJECTIVE: To evaluate the clinical value of a right subaxillary anterolateral minithoracotomy in open heart surgery in children with single congenital cardiac defects. METHODS: Twenty-five cases of children with congenital heart defects were operated through the right subaxillary anterolateral minithoracotomy, with 13 cases of the closure of atrial septal defect (ASD) and 12 cases of the ventricular septal defect (VSD). Accompanied abnormalities (2 cases with right ventricular outflow tract obstruction and 3 cases with partial anomalous pulmonary venous connection) were also corrected at the same time. RESULTS: All the patients were successfully operated. No operative mortality was noted. CONCLUSIONS: Except for complicated cardiac abnormalities, the right subaxillary anterolateral minithoracotomy is a safe and effective alternative to a median sternotomy for the correction of common cardiac defects.This approach is less invasive, produces small and hidden scars with optimal cosmetic appearance, and can avoid the postoperative pigeon breast.

OBJECTIVE: To explore diagnosis methods and therapeutic features in children with traumatic main bronchial rupture in order to improve the cure rate. METHODS: Early diagnosis, timely exploratory thoracotomy and prognosis were carried out in 8 children with main bronchial rupture from trauma. RESULTS: The group age ranged from 7 to 14 years. Seven cases were victims of traffic accidents and one injury from falling. Six cases were given early diagnosis and timely thoracotomy to have end-to-end anastomosis of bronchi. They completely recovered and had no complications. Two cases were delayed in diagnosis. One received end-to-end anastomosis 3 months after trauma,one had infection in lung and anastomotic stoma stenosis after operation and recovered through several laser treatments. The other had to have right pneumonectomy because of infection and pulmonary atelectasis 6 months after trauma. The group had no death after being fellowed up for one to ten years. Seven cases after end-to-end anastomosis recovered normal pulmonary function. One case of pneumonectomy resulted in middle pulmonary function obstacle. CONCLUSIONS: Enough attention should be paid to early diagnosis and timely thoracotomy of end-to-end anastomosis of bronchi of children with traumatic main bronchial rupture so as to improve efficacy and reduce complications.

Objective To study the alterations of micro-albuminuria (including IgG, Alb and β 2M) in childten with mycoplasma pneumoniae (MP) pneumonia. Methods Radioimmunoassay was used to detect the alterations of micro-albuminuria of mycoplasma pneumonia at different periods ( 46 cases at the acute period and 36 cases at the recovery period ). Thirty normal children were observed as the control group. Results Microalbuminuria levels of the acute period were significantly higher than those of the normal control group (P<0.01). The increase of micro-albuminuria levels was significantly correlated with exacerbation of the illness. During the recovery period, the level of IgG in the urine was reduced first (P>0.05); although the levels of Alb and β 2M in the urine were reduced obviously, they were still higher than that of the normal control group (P<0.05, P<0.01). Conclusions There are different degrees of kidney impairment in MP pneumonia children. Attention should be paid to protect kidnay function during the treatment of MP pneumonia.

Objective To study characteristics of heart rate variability (HRV) in the normal newborns. Methods Compas XM Holter system was used to analyze the time domain of HRV in 35 normal newborns. Results There was no difference in the parameters of HRV and heart rate indexes of newborns in the early period (1～7 d) and later period (8～28 d). There was moderate negative correlation between the standard deviation of all normal RR (SDNN) and the heart rate varibility index (HRVI) and average heart rate and minimum heart rate ( r :-0.44,-0.43,-0.51,-0.56, respectively P<0.05).Conclusions HRV parameters are stable indexes that reflect the function of the cardiac autonomic nervous system. The results may be referred to in the study of newborns' HRV.

Objective To study the relationship between febrile convulsion (FC) and attention deficit hyperactivity disorder (ADHD).Methods One hundred and seventy-two children with FC were examined using Conner's abbreviated symptom questionnaire by neurological pediatrician and followed-up for 5 to 10 years.Results There were 41 cases of ADHD in 172 cases of FC. The morbidity of ADHD was significantly higher in the children with FC (23.8%, 41/172) than that children without FC (5.1%, 14/273), (P<0.01).The morbidity of ADHD was significantly higher in the FC children with fits frequency ≥4 and fits duration ≥30 min than those FC children with fits frequency <4 amd fits duration <30 min. Conclusions The results suggest that multiple and prolonged convulsion is one of causes of ADHD in children.Anticonvulsants and prophylaxis should be given to children with FC and with a risk of recurrence and epilepsy.

Objective To study the long-term effect of cerebral hypoxia and ischemia (HI) on the central acetylcholine (Ach) system and its treatments in neonatal rats. Methods Neonatal rats (7 days after birth) were subjected to permanent left common carotid artery ligation followed by 90 min of hypoxia with 10% oxygen at 36 ℃. The Ach level was measured immediately after HI (Group 1) and 14 days after HI (Group 2) using basic hydroxylamine chromatometry. In Group 3, basic fibroblast growth factor (bFGF) was injected (4μg ip) for 7 days immediately after HI. bFGF was given in the same way 3 days after HI in Group 4. The Ach level was measured 2 weeks after HI in Groups 3 and 4. Results The Ach level in the left globe decreased significantly immediately after HI (P<0.05). It did not return to normal until 14 days after HI. bFGF did not change the decreased Ach level obviously. Conclusions HI can damage the central Ach system of neonatal rat, moreover, the abnormality can persist for a long time. The bFGF has no protective effect on the damages of the Ach system .

Objective To study the pharmacokinetics and cerebrospinal fluid penetration of baicalin in brain edema induced by pertussis bacilli in rabbits. Methods Baicalin concentrations of plasma and cerebrospinal fluid samples were determined by high-performance liquid chromatography. Results In plasma, area under the drug concentration-time curve (AUCp) was 30.63±9.21 μg/ml per hour, half-life (t 1/2p ) was 2.19±0.42 h, and time of maximum plasma concentration (Cmax p) was 56±7.6 μg/ml. In cerebrospinal fluid, AUCcsf was 10.29±5.6 μg/ml per hour, half-life (t 1/2csf ) was 2.31±0.37 h , maximum CSF concentration (Cmax csf) was 2.35±1.23 μg/ml, and time of maximum CSF concentration (tmax csf) was 2.33±0.4 h .The ratio of AUC in plasma and CSF (AUCcsf/AUCp) was 0.32 (>0.2). Conclusions There is a better CSF penetration of baicalin observed in infectious brain edema in rabbits.

Objective To explore the mechanism and effect of baicalin (BC), tetramethy1pyrazine (TMPZ) and mannitol (MN) on infectious brain edema induced by pertussis bacilli (PB) in rabbits. Methods Epidural intracranial pressure (ICP) was monitored continuously by fiberoptic ICP monitor. The activity of phospholipase A 2 (PLA 2) in serum and CSF, brain water contents (WC), Evan′s blue (EB), Na + contents, and the concentrations of malondialdehy (MDA) and superoxide dismutase (SOD) were determined. Results The activity of PLA 2 in serum and CSF of both BC and TMPZ groups were significantly lower at 3 hours and 5 hours than those of PB and MN groups (P<0.05). WC, EB, Na + contents and MDA concentrations in left brain tissues of all treated groups were significantly lower compared with that of the PB group, but SOD activity in brain tissues of all treated groups were significantly higher than that of the PB group. All groups BC, TMPZ and MN could reduced the intracranial hypertension (ICH), the effect of BC was the strongest, that of TMPZ and MN in proper order. Conclusions Both BC and TMPZ could inhibit the activity of PLA 2 in serum and CSF, and reduce the brain edema and intracranial hypertension induced by PB in rabbits.

Objective To observe the pathological changes in asthma after being treated with pulmonary surfactant (PS) dripped into the airway. Methods The asthmatic model was set up using guinea pigs immunized against ovalbumin. The pathological changes of bronchioles from five asthmatic animals and five treated ones were compared thirty minutes after the dripping of 0.3 ml PS into the airway. Results There were marked smooth muscle spasm, inflammatory cell infiltration and a large amount of exudate in the airway lumen in the asthma group. After being treated with PS, the inflammatory exudate disappeared and cell infiltration was alleviated. Conclusions Exterior PS could relieve spasm of bronchiole smooth muscle and alleviate airway inflammation.