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BackgroundStaged repair is common for complex conotruncal defects, often involving bidirectional Glenn (BDG) procedure. Following the cavopulmonary shunt, both Fontan completion and biventricular conversion (BiVC) serve as definitive approaches. The optimal strategy remains controversial.MethodsThe baseline, perioperative and follow-up data were obtained for all paediatric patients with conotruncal defects who underwent BDG procedure as palliation in Fuwai Hospital from 2013 to 2022. Patients with single ventricle were excluded. The primary outcome was mortality. The secondary outcome was reintervention, including any cardiovascular surgeries and non-diagnostic catheterisations.ResultsA total of 232 patients were included in the cohort, with 142 underwent Fontan (61.2%) and 90 underwent BiVC (38.8%). The median interstage period from BDG to the definitive procedure was 3.83 years (IQR: 2.72–5.42) in the overall cohort, 3.62 years (IQR: 2.57–5.15) in the Fontan group and 4.15 years (IQR: 3.05–6.13) in the BiVC group (p=0.03). The in-hospital outcomes favoured the Fontan group, including duration of cardiopulmonary bypass, aortic cross-clamp, mechanical ventilation and intensive care unit stay. Postoperative mortality was generally low and comparable, as was the reintervention rate (HR=1.42, 95% CI: 0.708 to 2.85, p=0.32). The left ventricular size was smaller at baseline and within the normal range at follow-up for both Fontan and BiVC groups; however, it was significantly larger with BiVC at follow-up.ConclusionIn paediatric patients with conotruncal heart defects who underwent BDG procedure, BiVC is a feasible option, especially for patients with certain Fontan risk factors, and are not ideal candidates for successful Fontan completion.

Lycopene (LYC) exerts a strong neuroprotective and antipyroptotic effects. This study explored the effects and mechanisms of LYC on chronic stress-induced hippocampal microglial damage and depression-like behaviors. The caspase-1 inhibitor VX-765 attenuated chronic restrain stress (CRS)-induced hippocampal microglial pyroptosis and depression-like behaviors. Moreover, the alleviation of CRS-induced hippocampal microglial pyroptosis and depression-like behaviors by LYC was associated with the cathepsin B/NLRP3 pathway. In vitro, the caspase-1 inhibitor Z-YVAD-FMK alleviated pyroptosis in highly aggressively proliferating immortalized (HAPI) cells. Additionally, the alleviation of corticosterone-induced HAPI cell damage and pyroptosis by LYC was associated with the cathepsin B/NLRP3 pathway. Furthermore, the cathepsin B agonist pazopanib promoted HAPI cell pyroptosis, whereas LYC inhibited pazopanib-induced pyroptosis via the cathepsin B/NLRP3 pathway. Similarly, Z-YVAD-FMK inhibited pazopanib-induced HAPI cell pyroptosis. These results suggest that LYC alleviates chronic stress-induced hippocampal microglial pyroptosis via the cathepsin B/NLRP3 pathway inhibition. This study provides a new strategy for treating chronic stress encephalopathy.

Advances in the prevention, diagnosis, and treatment for congenital heart disease (CHD), the most common birth defect in China, have drastically improved survival for individuals with the disease. However, China's current health system is not well prepared to manage the growing population of people with CHD and their complex medical needs, which range from early detection of the condition and intervention for physical, neurodevelopmental, and psychosocial impairment, to long-term management of major complications and chronic health problems. Health disparities caused by long-standing regional differences in access to care pose challenges when major complications such as pulmonary hypertension arise, and when individuals with complex CHD become pregnant and give birth. Currently, no data sources track neonates, children, adolescents, and adults with CHD in China and delineate their clinical characteristics and use of health resources. This scarcity of data should warrant attention from the Chinese Government and relevant specialists in the field. In the third paper of the Series on CHD in China, we summarise key literature and current data to identify knowledge gaps and call for concerted efforts by the government, hospitals, clinicians, industries, and charitable organisations to develop an actionable, lifelong framework of congenital cardiac care that is accessible and affordable for all individuals with CHD.

China has the largest number of individuals with congenital heart disease (CHD) in the world and a heavy burden of CHD. Therefore, understanding current CHD treatment outcomes and patterns in China will contribute to global progress in CHD treatment and be a valuable experience. Generally, CHD treatment in China has satisfactory outcomes owing to the joint efforts by all relevant stakeholders across the country. However, efforts are needed to overcome the remaining challenges: management of mitral valve disease and paediatric end-stage heart failure needs to be improved; cohesive paediatric cardiology teams should be established and collaboration between hospitals enhanced; CHD-related medical resources need to be more accessible and equitable; and nationwide CHD databases should be enhanced. In the second paper of this Series, we aim to systematically summarise the current CHD treatment outcomes in China, discuss potential solutions, and provide future perspectives.

Congenital heart disease (CHD), a wide spectrum of diseases with varied outcomes, is the most common congenital malformation worldwide. In this Series of three papers, we describe the burden of CHD in China; the development of screening, diagnosis, treatment, and follow-up strategies; and challenges associated with the disease. We also propose solutions and recommendations for policies and actions to improve the outcomes of CHD. In the first paper in this Series, we focus on prenatal and neonatal screening, diagnosis, and management of CHD. Based on advanced international knowledge, the Chinese Government has developed a network system comprising prenatal screening, diagnosis of CHD subtypes, specialist consultation appointments, and treatment centres for CHD. A new professional discipline, fetal cardiology, has been formed and rapidly developed. Consequently, the overall coverage of prenatal and neonatal screening and the accuracy of CHD diagnoses have gradually improved, and the neonatal CHD mortality rate has decreased substantially. However, China still faces several challenges in the prevention and treatment of CHD, such as insufficient diagnostic capabilities and unqualified consultation services in some regions and rural areas.

The existing agricultural insecticides have developed drug resistance from long-term use. Isoxazoline derivatives are new insecticides discovered in the 21st century. Because of their unique insecticidal mechanism, high selectivity, safety, and no significant cross resistance with the existing pesticides on the market, they have become a hot spot in the field of pesticide research. Herein, a series of novel isoxazoline derivatives containing ether and oxime-ether structures were designed and synthesized by a scaffold-hopping strategy using the pesticide fluralaner as a template structure. Through the investigation of insecticidal activity and the systematic structure–activity relationship, a series of compounds with high insecticidal activities were found, and compounds I-4, II-9, and II-13with LC50values of 0.00008–0.00036 mg/L against diamondback moth emerged as novel insecticide candidates. These compounds also exhibited broad spectrum fungicidal activities against 14 plant fungi. The current work provides a reference for the design of new isoxazoline compounds based on the scaffold-hopping strategy.

AbstractObjectives:Aortic valve repair in children is still a challenge. The aim of this study was to analyse the surgical results of children with aortic regurgitation who underwent single leaflet reconstruction using the Ozaki procedure in our medical centre.Methods:A retrospective study was conducted of nine children with aortic regurgitation who received single leaflet reconstruction from May 2017 to September 2019. Paired t-tests and Wilcoxon signed rank tests were used to compare the data at different time points.Results:The median surgical age was 4.7 (3.5, 6.4) years. Eight patients were pre-operatively diagnosed with severe aortic regurgitation, while one had moderate regurgitation. The left ventricles were significantly enlarged, with an average z-score of 3.8. Single leaflet reconstruction was carried out using glutaraldehyde-treated autologous pericardium under the standard Ozaki procedure. The median follow-up was 22 (14, 33) months. There was no post-operative death or re-intervention. One patient had moderate or more aortic regurgitation during the follow-up. The average degree of aortic regurgitation was mild, and the average z-score of the left ventricle decreased to −0.2 in the last follow-up.Conclusions:Single leaflet reconstruction using the Ozaki procedure was an effective surgical method for treating children with aortic regurgitation in our centre with satisfactory short-term results.

AbstractBackground:The research was to introduce the experience of doubly committed subarterial ventricular septal defect (DCVSD) repaired through tricuspid approach.Methods:From January, 2015 to September, 2019, 86 consecutive DCVSD paediatrics underwent repair via right subaxillary vertical incision (RAVI) through tricuspid approach. Perioperative and follow-up data were collected.Results:The age and weight at operation were 28.1 ± 18.5 (range: 7–101) months and 12.2 ± 4.2 (6–26.5) kg. There were two patients combined with discrete subaortic membrane, two patients with patent ductus arteriosus, one patient with atrial septal defect, and two patients with abnormal muscle bundle in right ventricular outflow tract. The mean size of ventricular septal defect was 7.0 ± 2.4 (3–13) mm. The defect was repaired with a piece of Dacron patch in 68 patients or directly with 1–2 pledgetted polypropylene sutures in 18 patients. The cardiopulmonary bypass time and aortic cross-clamp time were 46.2 ± 13.3 (23–101) minutes and 29.2 ± 11.5 (12–84) minutes. After 3.1 ± 2.4 (0–14) hours’ ventilator assist and 23.2 ± 32.1 (0–264) hours’ ICU stay, all patients were discharged safely. At the latest follow-up (27.9 ± 14.6 months), echocardiography showed trivial residual shunt in two patients. There was no malignant arrhythmia occurred and there was no chest deformity or asymmetrical development of the breast was found.Conclusions:DCVSD repaired via right subaxillary vertical incision through tricuspid approach was safe and feasible, providing a feasible alternative to median sternotomy, and it can be performed with favourable cosmetic results.

The prevalence and risk factors for failure to thrive (FTT) in pediatric patients with congenital heart disease (CHD) remain ambiguous. We aimed to investigate the prevalence, growth profiles, risk factors, and vulnerable subtypes of CHD associated with FTT in pediatric patients with CHD.

Thrombocytopenia is common for patients in the intensive care unit (ICU) and is associated with adverse outcomes. ICU thrombocytopenia in pediatric patients who underwent cardiac surgeries with cardiopulmonary bypass (CPB) is inadequately studied.

Traditional grey forecasting models cannot achieve satisfactory predictive accuracy on approximate non-homogeneous exponential sequence with acceleration, velocity and constant perturbation terms. Hence, it is hard to forecast the developing trend of non-homogeneous exponential data sequences widespread in the real world. It is for this reason that an extended intelligent grey forecasting model with variable speed and adaptive structure (VSSGM for short) is provided in this paper. The proposed model possesses three advantages, namely, strong adaptability to perturbation sequence, self-changing structure, and outstanding accuracy in simulation and prediction. One prominent property is that it can simulate/forecast any given inhomogeneous sequence with acceleration, velocity and constant disturbances, which are the most common perturbations widespread in nature and society. And the proposed VSSGM model can be reducible to DGM(1,1), NDGM, SAIGM and VCGM models in theory. Therefore, the proposed model outperforms the traditional grey models. In order to verify the effectiveness, universality, practicality and feasibility of the model, we conducted an experiment to analyze the precision of the model and employ it to simulate China's industrial added value from 2006 to 2015, then utilize it to forecast the industrial added values from 2019 to 2022. Comparing with the real statistic data, it shows that the proposed model has better prediction performance than traditional grey models. • VSSGM model has characteristics of varistructure and speed adaption. • Possess alterable structure and strong adaptability to perturbation sequence. • Simulate and forecast linear autoregressive sequence unbiasedly. • Proposed model has better performance than traditional GM(1,1) derived models. • China's industrial added value has been predicted effectively. [ABSTRACT FROM AUTHOR]

Surgery for complex congenitally corrected transposed great arteries is one of the greatest challenges in cardiovascular surgery. We report our experience with bidirectional Glenn shunt placement as a palliative procedure for complex congenitally corrected transposition.We retrospectively identified 50 consecutive patients who had been diagnosed with congenitally corrected transposition accompanied by left ventricular outflow tract obstruction and ventricular septal defect and who had then undergone palliative bidirectional Glenn shunt placement at our institution from January 2005 through December 2014. Patients were divided into 3 groups according to subsequent surgeries: Fontan completion (total cavopulmonary connection, 13 patients) (group 1), anatomic repair (hemi-Mustard and Rastelli procedures without Glenn takedown, 11 patients) (group 2), and prolonged palliation (no further surgery, 26 patients) (group 3).After shunt placement, no patient died or had ventricular dysfunction. Overall, mean oxygen saturation increased significantly from 79.5 ± 13.5 preoperatively to 94.1 ± 7.3 (P<0.001). The median time from shunt placement to Fontan completion and anatomic repair, respectively, was 2.1 years (range, 1.6–5.2 yr) and 1.1 years (range, 0.6–2.4 yr). Only 2 late deaths occurred, both in group 1. In group 3, time from shunt placement to latest follow-up was 4.5 years (range, 2.3–8 yr). At latest follow-up, mean oxygen saturation was 91.6 ± 10.3, and no patients had impaired ventricular function.Bidirectional Glenn shunt placement as an optional palliative procedure for complex congenitally corrected transposition has favorable outcomes. Later, patients can feasibly be treated by Fontan completion or anatomic repair. Use of a bidirectional Glenn shunt for open-ended palliation is also acceptable.

Cardiovascular diseases (CVDs) are one of the most urgent threats to humans worldwide, which are responsible for almost one-third of global mortality. Over the last decade, research on flexible electronics for monitoring and treatment of CVDs has attracted tremendous attention. In contrast to conventional medical instruments in hospitals that are usually bulky, hard to move, monofunctional, and time-consuming, flexible electronics are capable of continuous, noninvasive, real-time, and portable monitoring. Notable progress has been made in this emerging field, and thus a number of significant achievements and concomitant research prospects deserve attention for practical implementation. Here, we comprehensively review the latest progress of flexible electronics for CVDs, focusing on new functions provided by flexible electronics. First, the characteristics of CVDs and flexible electronics and the foundation of their combination are briefly reviewed. Then, four representative applications of flexible electronics for CVDs are elaborated: blood pressure (BP) monitoring, electrocardiogram (ECG) monitoring, echocardiogram monitoring, and direct epicardium monitoring. Their operational principles, progress, merits and demerits, and future efforts are discussed. Finally, the remaining challenges and opportunities for flexible electronics for cardiovascular healthcare are outlined.

Low socioeconomic status is associated with increased mortality for patients with cardiovascular disease; however, the effect of family socioeconomic status on the prognosis of children with congenital heart disease remains unclear, particularly in low-income and middle-income countries. We aimed to examine the association between family socioeconomic status and postoperative outcomes for paediatric patients with complex congenital heart disease (CCHD).

Repair of tetralogy of Fallot in young children prolongs their survival but could be associated with heightened risk of postoperative pulmonary regurgitation (PR), which significantly increases volume overload in the right ventricle.

Economic data on congenital heart disease (CHD) in China are scarce. Therefore, this study aimed to explore the inpatient costs of congenital heart surgery and related healthcare policies from a hospital perspective.

Introduction:According to Reports on the Prevention and Control of Birth Defects in China, the total lifelong economic burden of new congenital heart diseases (CHD) cases was more than 12.6 billion Chinese Yuan. We aim at exploring the economic burden driven by congenital heart surgery and filling the gap in the health economics in China.Methods:We used data from CDCHS database (Registry No. ChiCTR1800014577) to prospectively analyze the economic burden of congenital heart surgery. The total expenditures were divided into eleven subjects and classified by STAT category, year, and different types of CHD. Stepwise multivariable linear regression model was utilized to analyze the contributing factor to the total expenditure. National economic data was accessed to better describe the burden.Results:A total of 6568 hospitalizations were enrolled from 2018 to 2020. The median of total expenditure of all enrolled patients during hospitalization was 63,129.14 (≈9,910.52 USD), and significant cost-related difference was defined among the five STAT categories (P<0.001) with the lowest in STAT-1 (55,720.43, ≈8,747.46 USD) and highest in STAT-5 (190,587.01, ≈29,919.94 USD). The median total costs during the 3-year 2018 to 2020 period were 57,248.72 (≈8,987.38 USD), 63,423.45 (≈9,956.74 USD) and 67,867.37 (≈10,654.39 USD), respectively. Multivariable linear regression model showed that STAT category, complication, emergent operation and delay sternal closure were the major contributing factor to the total expenditure.Conclusions:For the first time, the economic burden of congenital heart surgery in China is delineated not only in terms of total expenditure but also the detail components. Also, the current healthcare policies in China were analyzed, and combined with the expenditure information, this analysis provides substantial information about specific factors driving to the economic burden with the purpose of aiding policy adjustments.

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This study examined early postoperative results to identify perioperative factors that are associated with prolonged mechanical ventilation (PMV) in tetralogy of Fallot (TOF) patients undergoing corrective surgery. We retrospectively examined the role of perioperative variables in determining the period of mechanical ventilatory support in TOFpatients undergoing corrective surgery. A total of 821 patients were included in the study. The cohort was divided into a PMVgroup that included patients with >90th percentile for duration of mechanical ventilation and a non‐PMVgroup which included all other patients. Non‐PMVgroup consisted of 751 patients (454 males, 297 females; median age 12 months, interquartile range 8–19 months; mean weight 9.60 ± 2.98 kg). PMVgroup consisted of 70 patients (51 males, 19 females; median age 8 months, interquartile range 6.75–13 months; mean weight 8.64 ± 1.95 kg). No patients died in the non‐PMVgroup compared with two deaths due to acute respiratory distress syndrome in the PMVgroup. Univariate risk factors for PMVincluded age, weight, left ventricular end‐diastolic volume index (LVEDVI), McGoon ratio, Nakata index, previous palliative operations, cardiopulmonary bypass (CPB) time, aortic cross‐clamp (ACC) time, preoperative major aortopulmonary collateral arteries (MAPCAs) occlusion by coils in hybrid procedure, postoperative right ventricular/left ventricular systolic pressure ratio, central venous pressure (CVP), left atrial pressure (LAP), endotracheal reintubation, vasoactive‐inotropic score (VIS), renal replacement therapy, and early‐onset ventilator‐associated pneumonia (VAP). In a multivariable model, age, LVEDVI, McGoon ratio, Nakata index, previous palliative operations, CPBtime, blood returning to left atrium during surgery as a surrogate marker for significant aortopulmonary collateral presence, and early‐onset VAPwere the independent risk factors for PMV. The risk factors for PMVwere age, LVEDVI, McGoon ratio, Nakata index, previous palliative operations, CPBtime, VIS, LAP, blood returning to left atrium during surgery, and early‐onset VAP.

Based on multiple types of data, the topographical features of the Okinawa Trough (OT) have been characterized and a computation method has been proposed to determine the break point of continental shelf (BOS), foot point of the continental slope (FOS), the central axial point, and the maximum depth point. A total of 48 topographical profiles that crosscut the continental slope have been used to determine the trends of the BOS and FOS (the BOS and FOS lines) in the East China Sea (ECS). The trend of central axial points in the OT has been similarly determined by analyzing 39 topographical profiles across the axis of the trough. The BOS line forms the boundary between the continental shelf and slope. In the ECS, the BOS line roughly follows the 200 m isobath, continuously in the northern and middle parts of the OT, but jumping about somewhat in the south. The FOS line is the boundary between the continental slope and the bottom of the trough. The depth of the FOS increases gradually from north to south in the OT. Intense incisions by canyons into the slope in the southern part of the trough have led to the complex distribution of FOS. Topographical profiles crosscutting the northern, middle, and southern parts of the OT exhibit features that include: a single W-shape, a composite W-shape, and a U-shape, respectively, which suggests that in the middle and northern parts of the trough the central axial points are always located on seamount peaks or ridges associated with linear seamounts, whereas in the south they are found in the center of en echelondepressions. The line formed by the central axial points is the east-west dividing line of the OT, which indicates that the trough is a natural gap that prevents the extension of ECS continental shelf to the east. The distributions of the BOS and FOS lines are influenced by fluctuation of sea levels and submarine canyons, whereas the distribution of axis lines is controlled by tectonics and deposition.

ABSTRACTDuring 2012, we identified sampled dogs with elevated levels of antibodies (=1:40) against A(H1N1)pdm09 virus by using a hemagglutination inhibition (HI) assay (seroprevalence, 24.7%) and a microneutralization (MN) assay (seroprevalence, 10.8%). These high seroprevalences of A(H1N1)pdm09 among dogs without clinical signs of influenza support the premise that dogs may play a role in the human influenza ecology in China.

The optimal myocardial protection strategy for newbornsinfants undergoing congenital heart surgery remains controversial. The purpose of this study was to compare myocardial protection using histidine-tryptophan-ketoglutarate (HTK) and cold blood cardioplegia in a neonatal piglet model. Twenty-one piglets were randomized to three groups: the control group (C group, n = 7), a single dose of HTK group (H group, n = 7), and multidose cold blood cardioplegia group (B group, n = 7). Animals in the two experimental groups were placed on hypothermic cardiopulmonary bypass, after which the ascending aorta was clamped for 2 hours. Immediately after declamping, both the difference between arterial and coronary sinus blood lactate concentrations and the oxygen extraction did not differ between the H group and the B group. At 3 hours after declamping, rise in serum troponin-T and creatine kinase isoenzyme MB levels showed no significant differences between the H group and the B group (p= 0.735 and p= 0.103, respectively). No significant differences were noted in the myocardial lactate content, ATP content, and histopathological score between the H group and the B group (p= 0.810, p= 0.158, and p= 0.399, respectively). Transfusion requirement in the B group was significantly more than that in the H group (p= 0.003). HTK solution provides equivalent myocardial protection to multidose cold blood cardioplegia for the neonatal heart with less transfusion requirement.

Introduction:Congenital heart disease (CHD) is the leading birth defect worldwide. We report trends in CHD mortality in 204 countries and territories over the past 30 years, and associations with age, period, and birth cohort.Methods:Cause-specific CHD mortality estimates were derived from the Global Burden of Disease study 2019. We utilized an age-period-cohort model to estimate overall annual percentage change in mortality (net drifts), annual percentage change from 0-4 to 65-69 years (local drifts) and period (cohort) relative risks between 1990 and 2019.Results:Global CHD deaths in 2019 were 217,000 (95%UI: 177,000, 262,000). India, China, Pakistan and Nigeria were the top 4 countries accounting for 39.7% of deaths globally. The reduction in age-standardized mortality ranged from 66.3% in high-sociodemographic index (SDI) countries to 30.5% in low-SDI countries. Globally, there was an emerging transition in the age distribution of deaths from pediatric to adult population, except for an increasing trend of mortality in 10~34 years in Mexico and Pakistan. During 1990-2019, favorable mortality reductions were found in most high-SDI countries like South Korea (net drift = -4.0% per year) and United States (-2.3%), and also in many middle-SDI countries like Brazil (-2.7%) and a few low-SDI countries like Ethiopia (-2.3%). However, 52 out of 129 countries with at least 50 deaths had either increasing trends (net drifts≥0.0%) or stagnated reductions (≥-0.5%) in mortality. The relative risk of mortality generally showed improving trends over time and in successively younger birth cohorts among high- and high-middle SDI countries except Saudi Arabia and Kazakhstan. Fourteen middle-SDI countries such as Ecuador and Mexico, and sixteen low-middle-SDI countries like India and twenty low-SDI countries like Pakistan, had unfavorable or worsening risks for recent periods and birth cohorts.Conclusions:Improvements in the treatment of CHD should reduce the risk for successively younger cohorts and shift the risk for all age groups over time. Although there were gains in CHD mortality globally, unfavorable period and cohort effects were found in many countries, raising questions about adequacy of their health care for CHD patients across all age-groups.

Introduction:Congenitally corrected transposition of the great arteries (ccTGA) is a rare and complex congenital heart disease with the characteristics of double discordance. Enormous accompanied anomalies are the culprit of difficult prognosis evaluation and clinical decisions.Hypothesis:To delineate a novel ccTGA clustering modality under HPO instruction and elucidate the relationship between phenotypes and prognosis in ccTGA patients.Methods:A retrospective review of 270 patients diagnosed with ccTGA in Fuwai hospital from 2009 to 2020 and cross-sectional follow-up was performed. Human Phenotype Ontology (HPO)-instructed clustering method was administered in ccTGA classification. Kaplan-Meier survival, Landmark analysis, and cox regression analysis were used to investigate the difference of outcomes between clusters with the combination of surgeries.Results:The median follow-up time was 4.29 (2.07-7.37) years. A total of three distinct phenotypic clusters were obtained after HPO-instructed classification with 21 in cluster 1, 136 in cluster 2, and 113 in cluster 3. Landmark analysis revealed significantly worse mid-term outcomes in all-cause mortality (p=0.042) and composite endpoints (p=0.008) of cluster 3 in comparison with cluster 1 and cluster 2. Multivariate analysis indicated that pulmonary arterial hypertension (PAH), atrioventricular septal defect (AVSD), and arrhythmia were risk factors for composite endpoints. Moreover, the surgical treatment was significantly different among the three groups (p<0.001) and surgical strategies had different effects on the prognosis of the different phenotypic clusters.Conclusions:HPO-instructed clustering method delineates a novel image of ccTGA classification that might improve prognosis prediction and clinical decision.

The purpose of this study was to report retrospectively the summarized clinical findings from 20 consecutive pediatric extracorporeal membrane oxygenation (ECMO) patients and to investigate the factors associated with mortality. The ECMO circuit system was completely covered using heparin-coating technique, and venoarterial ECMO was used in all patients. Heparin dosage was 4–20 U/kg/h and active clotting time was maintained between 146 and 360 seconds. ECMO was weaned off successfully in 15 patients (75%); 11 of 15 patients (73%) survived and were discharged from the hospital; 4 of 15 patients died of postoperative complications; 5 patients failed to be weaned off ECMO. The percentage of discharged patients was 55% (11 of 20) in this cohort study. Lactic acid concentration of artery blood before ECMO in survivor patients was significantly lower than in nonsurvivor patients (p0.009); patient weight between two groups also had statistical difference (p0.046). ECMO effectively treats cardiac and pulmonary failure secondary to cardiac surgeries for complicated congenital heart diseases. Early application of ECMO in patients with cardiac and respiratory failure is still the key point of success in preventing vital organs from irreversible damage.

By the reaction of a sterically hindered arenethiol, 2,4,6-Pri3C6H2SH, with Cd(NO3)2·4H2O under different conditions, the colourless salt of trinuclear cadmium cluster anion complex [NMe4][Cd3(SC6H2Pri32,4,6)7]. C5H12 (1) and the uncharged trinuclear cadmium complex [Cd3(SC6H2Pri32,4,6)6(HSC6H2Pri32,4,6)]°CH3OH·7H2O (2) have been synthesized. These have in turn been structurally characterized. Crystals of (1) are monoclinic, space group P21ln with a = 19.629(6), b = 25.608(9), c = 25.450(9)Å, β = 107.54(3)°, V- 12203(7)Å3, Z = 4, R = 0.076 for 3839 observed reflections. Crystals of (2) are triclinic, space group P1 with a = 19.792(10), b = 20.508(12), c = 33.97(2)Å, α = 85.81(5), β = 86.77(5), γ = 85.12(4)°, V = 13686(14)Å3, Z = 4, R = 0.0921 for 8327 observed reflections. The core of the cluster anion of (1) [Cd3(SC6H2Pri32,4,6)7]- is formed by a defect cubane unit with three cadmium and four sulphur atoms at its vertices. Each cadmium atom exhibits tetrahedral coodrination with one terminal sulphur, two doubly bridging sulphur and one triply bridging sulphur atoms. In complex (2), three cadmium atoms are coordinated by six thiolate (RS-) and one thiol (RSH) ligands. Two of three cadmium atoms have tetrahedral coordination and one is trigonal planar.

Left main coronary arterial (LMCA) atresia is a rare coronary arterial anomaly with extremely limited data on the optimal management. We aimed to report our single-surgeon experience of the ostioplasty in patients with LMCA atresia.

ABSTRACTInfection of domestic cats with (H1N1) pandemic 2009 (pdm09) influenza A virus has recently been documented. In this paper, we report for the first time the sporadically current seroprevalence of (H1N1) pdm09 influenza A virus infection in cats in China. Thirteen of 1,080 sera were found positive by nucleoprotein (NP)-specific enzyme-linked immunosorbent assays (ELISAs) in different cat populations in southern China. It is very important to stress further surveillance of pandemic (H1N1) 2009 influenza A virus in cats in southern China.

To compare the clinical results of different surgical approaches for congenital heart disease in pediatric patients, 1,669 cases of atrial septal defect, ventricular septal defect, or tetralogy of Fallot, which were corrected from January 1999 to December 2001, were classified according to approach (sternotomy, ministernotomy, or minithoracotomy). In cases of ventricular septal defect, the incidence of pulmonary complications was significantly higher in the minithoracotomy group than in the full sternotomy or ministernotomy groups. In patients with tetralogy of Fallot, hemoglobin concentration was higher, oxygen saturation was lower, and more patients required a transanular patch in the sternotomy group than in the other groups, but the clinical results were similar. Patients with complex defects or severe pulmonary hypertension should undergo a full sternotomy.