Objective To analyze the changes of energy metabolism-related proteins(enzymes) and transformation of energy metabolism in transplanted heart.Methods The hearts transplanted from Lewis to Wister rats as allografts and from Lewis to Lewis rats as isografts were used to estab- lish Ono model.The changes in proteins were observed by using proteomics technique and compared between allografts and isografts in the left ventricular myocardial tissues 2 and 8 weeks after heart transplantation.Peptide mass fingerprint map was obtained by using matrix-assisted laser desorption/ ionization time of flight mass spectrometry(MALDI-TOF-MS)and the matched proteins achieved by using Matrix Science software.Results Eighty proteins(enzymes)of total 65 differential proteins that regulated energy metabolism were identified in allografted hearts,which correlated to the Krebs cycle and electron transport system involving glycometabolism,fatty acid and branched-chain amino acids oxidation.Conclusion The energy metabolism in allografts heart was transformed:mitochondria function was decreased in Krebs cycle but enhanced in electron transport system and outer mitoehon- drial membrane permeability to ATP,accelerated in glycolysis and fatty acid oxidation,however, branched-chain amino acids oxidation were suppressed.

OBJECTIVE: To measure the concentrations of soluble intercellular adhesion molecule-1 (s-ICAM-1), soluble vascular cell adhesion molecule-1 (s-VCAM-1), and von Willebrand factor (vWF) in the plasma of patients with rheumatic heart disease (RHD), and to provide basic theory for the mechanism of valvular and myocardial damage. METHODS: The consecutive patients with RHD (n=40) and healthy people (n=40) were chosen. All blood samples were taken from the peripheral veins. s-ICAM-1, s-VCAM-1 and vWF levels in all samples were measured by enzyme-linked immunosorbant assay. RESULTS: s-ICAM-1, s-VCAM-1 and vWF levels were significantly elevated in patients with RHD compared with healthy people (P < 0.01. The level of sICAM-1 was elevated in patients with atrial fibrillation compared with patients without atrial fibrillation. CONCLUSION The concentrations of s-ICAM-1, s-VCAM-1 and vWF levels were significantly elevated in patients with static rheumatic fever, which might be one of the pathogenic mechanisms of valvular damage, endothelial dysfunction, and myocardial damage in rheumatic heart disease.
Adult ; Atrial Fibrillation ; blood ; Female ; Humans ; Intercellular Adhesion Molecule-1 ; blood ; Male ; Middle Aged ; Rheumatic Heart Disease ; blood ; Vascular Cell Adhesion Molecule-1 ; blood ; von Willebrand Factor ; metabolism

OBJECTIVE: To review the management of NUSS procedure by video-assisted thoracoscopy for the correction of pectus excavatum in 18 patients, and to prevent and treat some complications. METHODS: Eighteen patients with severe pectus excavatum underwent NUSS procedure by video-assisted thoracoscopy from December 2006 to September 2007. RESULTS: The operation time ranged from 30 to 70 min ( average 45 min). Good Results were achieved for all patients after the operation. All of them recovered and were discharged 5 approximately 7 days after the operation. Minor complications occurred in 2 patients. CONCLUSION NUSS procedure is microinvasive and has beautiful outlook with shorter operation time and simple handling.The minimally invasive technique has a low complication rate with satisfactory short-term result. Proper management is important for the recovery at the early postoperative stage.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Funnel Chest ; surgery ; Humans ; Male ; Minimally Invasive Surgical Procedures ; instrumentation ; methods ; Thoracic Surgery, Video-Assisted ; methods ; Thoracic Surgical Procedures ; methods ; Thoracoscopy ; methods

Objective To understand the prevalence and risk factors of agricultural activities related injuries among rural residents in Shandong province. Methods A retrospective investigation was conducted among agricultural profession-related workers in 20 villages with multistage cluster sampling method in Shandong province. Four times face-to-face interview were conducted by trained interviewers, including 32 students and local medical personnel under constructed questionnaires.Accidental injuries occurred in the activities or in the agricultural profession-related jobs were recorded, from May 1st 2009 to April 30st 2010. Data was input and analyzed by SPSS 13.0 statistical software. Results A total of 837 cases reported at least 1 job-related injury out of the 11 902 people who had been surveyed in one year. The crude incidence rate was 7.03% and the standardized incidence rate was 7.36%, higher in males (9.01%) than in females (4.10%), X2= 105.53, P=0.000.Children and adolescents (≤ 14 aged) had the higher incidence rate (9.50%), X2=9.70, P=0.008.People working in the area of commercial service related to agricultural products had the highest incidence rate (12.94%). In particular, those occupations that related to agricultural construction or materials appeared to have had higher incidence rates as 16.80% and 15.59% respectively, than other kinds of jobs (X2= 167.30, P=0.000). There were higher proportion of injuries occurred in the roads (28.79%), in the fields(28.08%) during labor work(38.00%) transportation(27.97%), respectively.The seasonality of agricultural injures mostly occurred between June and August, accounted for 47.43%. Major external causes related to injuries were instruments or tools (31.42%) being used,transportation (24.13%) and falls (20.19%). Wounds on limbs took the majority (56.39%). The accidental self-inflicted injury occupied 76.82%, while accidents to passive injuries occupied 11.47%,other kinds accounted for 11.71%. Most of the accidents caused mild or moderate damage, accounted for 60.22% and 30.34% respectively. 7 cases died of injuries, with the fatality rate as 0.84% and the mortality rate was 58.81 per one hundred thousand. 72 cases ended up in disability caused by injuries,with the morbidity rate as 6.05 per thousand. Answers to the major internal causes of injuries appeared to be: "did not know how to protect oneself" (29.87%) with females (45.41%) in particular,followed by "over fatigue" and "inappropriate treatment" which took the 2nd place in males. Major natural environmental factors of injuries would relate to "high air temperature and humidity but lower wind velocity"(14.93%), "unclear signs on the country road"(12.19%), "the sky was cloudy or dark"(10.87%), "slippery road caused by rain or snow" (10.51%), "kids were unintended" (10.27%) etc.Most of the wounded received treatment clinically (50.18%), with the percentile (P50) of medical cost as 182.76 RMB (Yuan). The proportion of inpatient was 27.72% and with percentile of time as P50=7.57 day and cost as P50=2840.00 RMB Yuan. The wounded had a rest of P50=5.9 days, with an indirect cost as P50=233.16 RMB Yuan. Conclusion The results of this study indicated that the incidence of agricultural profession-related injuries was high, with serious harm. Behavioral intervention and awareness of injuries should be enhanced, together with the improvement of environmental condition.

OBJECTIVE: To determine the protective effects and mechanism of ulinastatin on the lung injury during cardiopulmonary bypass (CPB). METHODS: Thirty patients with rheumatic heart disease (RHD) were divided into 2 groups randomly. The ulinastatin group (Group U, n = 15) received 1 x 10(4)U/kg ulinastatin intravenously before the CPB and the same amount of ulinastatin was added into the primary solution. The control group (Group C,n = 15) received normal saline instead of ulinastatin. A brochioalveolar lavage was performed at 2 h after the cardiopulmonary bypass. Polymorphonuclear neutrophil elastase, tumor necrosis factor-alpha and MDA contents in the brochioalveolar lavage fluids were measured, and the lung oxygenate index was measured preoperatively and at 1 and 4 h after CPB termination. RESULTS: Polymorphonuclear neutrophil elastase, tumor necrosis factor-alpha and MDA contents of Group U in the brochioalveolar lavage fulids were significantly lower than those of Group C (P < 0.05), and the lung oxygenate index of Group U at 1 and 4 h after CPB termination was also significantly lower than that of Group C. A significant increase of lung oxygenate index occurred in both groups at 1 and 4 h after CPB when compared with the same group at the baseline before CPB (P < 0.05). CONCLUSION Ulinastatin has the protective effects on the lung injury during CPB by decreasing polymorphonuclear neutrophil elastase, alleviating lung inflammatory reaction and reducing oxygen free radicals.
Adolescent ; Adult ; Aged ; Bronchoalveolar Lavage Fluid ; Cardiopulmonary Bypass ; Female ; Glycoproteins ; therapeutic use ; Humans ; Leukocyte Elastase ; metabolism ; Male ; Middle Aged ; Protective Agents ; therapeutic use ; Respiratory Distress Syndrome, Adult ; prevention & control ; Rheumatic Heart Disease ; surgery ; Trypsin Inhibitors ; therapeutic use ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVE: To investigate the role of connective tissue growth factor (CTGF) in pulmonary allograft fibrosis in rats. METHODS: The lungs of 20 Wistar rats were transplanted into 20 Sprague-Dawley(SD) rats. Ten allograft lungs were harvested 1 week postoperatively (acute rejection group,AR); the other 10 allografts were harvested 6 weeks postoperatively (chronic rejection group,CR); and ten normal Wistar rats served as a control group(normal lung, NL). Paraffin embedded sections of the harvested lung specimens were stained with hematoxylin and eosin (HE), Van Gieson (VG) for the examination of tissue morphology under the microscope. The scores of lung fibrosis were measured and the wet/dry ratio of the lung specimens was evaluated. The CTGF expression was determined by immunohistochemical method. RESULTS: The wet/dry ratios of lung decreased gradually(AR group vs. control group: 3.48+/-0.47 vs. 4.67+/-0.51, P<0.05; CR group vs. AR group: 2.85+/-0.52 vs. 3.48+/-0.47, P<0.05). The transplanted lungs showed massive lymphocytic infiltration, interstitial fibrosis, destroyed alveolus architecture, obliterative bronchiolitis, and lung tissue consolidation. These pathological changes were more severe in the CR group than in the AR group, but there were no such changes in the control group (scores of pulmonary fibrosis: NH, 0.00+/-0.00; AR, 0.98+/-0.47; CR, 2.35+/-0.52; AR vs. NH, P<0.01; CR vs. AR, P<0.01). CTGF was not expressed in the normal rat lungs (0.00+/-0.00); however, it was detected in the lung allograft after the operation. The CTGF expression in the CR group was significantly higher than that in the AR group (P<0.01). CONCLUSION The expression of CTGF protein is related to the transplanted pulmonary fibrosis,and is involved in the pathogenesis of transplanted pulmonary fibrosis.
Allografts ; pathology ; Animals ; Connective Tissue Growth Factor ; metabolism ; Fibrosis ; Lung ; metabolism ; pathology ; Lung Transplantation ; Male ; Pulmonary Fibrosis ; metabolism ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar

OBJECTIVE: To observe the structural and hemodynamic changes after the reconstruction of right ventricular outflow tract (RVOT) with valved bovine jugular vein conduit (BJVC) in the canine model by color Doppler echocardiography (UCG). METHODS: BJVC was used in the reconstruction of RVOT of 32 canines. UCG was used to observe the structure of the right ventricle and RVOT. The structure and hemodynamics were observed, and the diameter, width, blood velocity and pressure gradient (PG) were measured between the right ventricle and the conduits. RESULTS: In the first stage, UCG showed that PG between the right ventricle and BJVC was high in 5 canines, and a few anastomosis in BJVCs with main pulmonary artery was small. Blood velocity quickened and PG increased, and color Doppler showed that the bloodstream was very bright. In the second stage, 7 canines survived for 1 year after the implantation. One year after the operation, UCG showed that the valve closed well, no graft kinking or obvious regurgitation of the valve was observed. The PG of the valve was low. The BJVCs were unobstructed and there was no thrombus.All the valves of BJVC opened well except one. In the third stage, 20 canines survived for 1 year after the implantation. UCG showed that the valve motion was good, no graft kinking or obvious regurgitation of the valve was observed. No neoplasm was observed. CONCLUSION UCG is one of the most useful measurements in the structural and hemodynamic study of RVOT reconstruction by BJVC in the canine model. The good evaluation of UCG implies that it is important for the study and clinical practice.
Animals ; Blood Vessel Prosthesis ; Cattle ; Dogs ; Echocardiography, Doppler, Color ; Female ; Heart Ventricles ; diagnostic imaging ; surgery ; Hemodynamics ; Jugular Veins ; diagnostic imaging ; transplantation ; Male ; Pulmonary Artery ; diagnostic imaging ; surgery

OBJECTIVE: To summarize the clinical application of bioprosthetic valve replacement. METHODS: Fifty two patients, aged 13-73(52.4+/-14.0) years, underwent cardiac valve replacement with biovalves from June 2002 to June 2006 in our hospital. Fifty three tissue valve replacements combined with 8 mechanical valve replacements were performed. Other procedures were also carried out if appropriate, including bidirectional Glenn shunt in 1 patient with double outlet of right ventricle and pulmonary artery stenosis; interruption of accessory pathway in 1 patient with Wolff-Parkinson-White syndrome; coronary artery bypass graft in 5 with severe coronary artery disease; and atrial or ventricular repair in 4 with congenital septum defects. RESULTS: One patient died in hospital due to multiple organ failure. The hospital mortality rate was 1.9%. The mean follow-up was 25 months. Two patients lost follow-up and the follow-up rate was 96%. Forty one patients returned to NYHA class I, 9 to class II, and 1 to class III. Echocardiography showed the implanted bioprosthesis functioned well without stenosis or regurgitation. There was no structural deterioration with freedom from thromboembolism and anticoagulant hemorrhage in all patients. CONCLUSION The efficacy of biovalves in heart valve replacement is satisfactory.
Adolescent ; Adult ; Aged ; Bioprosthesis ; Female ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Retrospective Studies ; Tricuspid Valve ; surgery

OBJECTIVE: To evaluate the therapeutic effect of remaining integrated mediastinal pleura upon the aortic arch and performing the anastomosis at the left cervix in radical operation for esophageal carcinoma. METHODS: Ninety-eight patients with esophageal carcinoma were treated with the operation mentioned above. Among them, 56 patients had cancer in the middle, 12 in the upper-middle, 24 in the lower-middle segments, and 6 had double-primary tumors, with carcinoma length of (5.2+/- 2.4) cm. The TNM stages were 6 of Stage I and 92 of Stages II-III. All cases were squamous cell carcinomas. RESULTS: All patients had satisfactory operation processes, without perioperative death, chylothorax, dyspnea, gastric retention, incision infection, and severe gastro-esophageal reflux. The life quality of the patients was improved. CONCLUSION The radical operation with remaining integrated mediastimal pleura upon the aortic arch and anastomosis at the cervix for treating esophageal carcinomas is of minimal invasion with fewer complications, and may be used in clinical practice.
Aged ; Anastomosis, Surgical ; methods ; Aorta, Thoracic ; surgery ; Carcinoma, Squamous Cell ; surgery ; Esophageal Neoplasms ; surgery ; Female ; Humans ; Male ; Middle Aged ; Pleura ; surgery ; Thoracic Surgical Procedures ; methods

Since the outbreak of novel coronavirus pneumonia, the World Health Organization and the National Health Commission have issued multiple guidance documents.Medical facilities across the nation have actively implemented the countermeasures in response to the epidemic.However, in the real scenario of prevention and control, hospital infection remains a great concern.It is crucial to formulate measures and procedures based on standard prevention and transmission route prevention to avoid cross infection between medical workers and patients.Based on the practice, we summarize the institutional management, layout process, prevention and control of hospital infection in the emergency wards for further discussion and improvement.