Objective　To introduce the technique of mitral v alve replacements in beating heart, and review the clinical experience in 234 ca ses of operation. Methods　A total of 234 patients of mitral val ve replacement in beating heart with mild hypothermic extracorporeal circulation (30～32 ℃) were reviewed. Results　 The procedures underwe nt fluently and only 2(0.85%) died early postoperatively. No low cardiac output , arrhythmia and cer ebral embolism complications was found. Conclusion　Results sugg ested that mitral valve replacement in beating heart is a safe and available method and is good in extenuating myocardial and pulmonary i njury from ischemia-reperfusion and deep hypothermia.

Objective　To compare the clinical efficiency of intracardiac procedures on traditional cardioplegic arrested-heart and on-pu mp beating-heart for congenital heart disease (CHD) with severe pulmonary hyper tension. Methods　Among all 153 cases, 95 cases underwent operat ions on cardioplegic arrested-heart, while 58 on-pump beating-heart. In arres ted-heart group, 79 cases with ventricular septal defect (VSD), 13 with atria l septal defect (ASD) and 3 with patent ductus arteriosus (PDA) were examined whi le in beating-heart group, 43 cases with VSD, 10 with ASD, and 5 with PDA were examined. Results　There were 12 cases of operative death (12.6%) and 8 of tracheotomy (8.4%) in heart arrested group. No operative death and tracheotomy in beating-heart group. 141 patients were followed up for 3 months to 10 year s with good recovery. There were 2 cases of right heart function failure six yea rs later in arrested-heart group. Conclusion　Results sugges t that on-pump beating-heart technique is superior to traditional cardiopl egic arrested-heart for CHD with severe pulmonary hypertesion. The cause might be t hat on-pump beating-heart intracardiac operation is more effective in cardio pulmon ary protection.

Objective To observe the effect of propofol on cognitive functions and hippocampus tissue in hyperlipidemia aged rats.Methods Seventy-six aged male SD rats were selected and randomly divided into basal diet with propofol injection (group PI), basal diet with normal saline injection(group N1), high-fat diet with propofol injection (group P2) and high-fat diet with normal saline injection (group P2), with 19 rats in each group.Eight weeks later,group P1 and P2 received intraperitoneal injection of propofol 100 mg · kg-1 · d-1 for 5 days.While in group N1 and N2, rats received the same intraperitoneal injection of equal volume normal saline.One day after the last injection, escape latency and space exploration were detected by Morris water maze in the next six days.One hour after the last water maze test, the serum and hippocampus were sampled to detect the expression of beta-amyloid protein and receptor for advanced glycation endproducts(RAGE) by immunohistochemical method and ELISA respectively.Results In place navigation tests,the escape incubation period(98.20±25.40)s in group P1 was obviously longer than that in N 1 group (47.50± 11.08) s (P＜ 0.01).Compared with P2 (99.79 ± 20.38) s, escape incubation period was shortened in N2 (50.70± 20.55) s (P＜ 0.05).There was no significantly difference between N2 and N1 (P＞0.05), while the escape incubation period in group P2 was longer than P1 (P＜ 0.05).In spatial probe test,platform passing number ((2.86 ±1.46)times) in group P1 were less than that in N1 group ((7.50± 1.70) times, P＜0.05).In group N2, the platform passing number ((6.60 ±3.91) times) were more than those in group P2 ((1.16 ±1.16)times, P＜0.05) while there was no significant difference between group N1 and N2 (P＞0.05).Times of crossing platform in group P2 were less than that in P1 group (P＜0.05).Compared with group N1((147.83±60.88) ng/L) and N2((152.73±87.50) ng/L) ,the expression of RAGE protein was increased in group P1((629.89±110.33) ng/L) and P2((229.89±53.20) ng/L) (P＜0.05).There was no significant difference between N1 and N2 groups(P＞0.05) ,while the expression of RAGE protein in P1 group was lower than that of P2(P＜0.05).In immunohistochemical test, positive expression cells in P1 ((18.49± 1.53) and P2 (25.67±3.08)) were higher than that in group N1(9.33±2.31) and group N2(12.14±2.52) (P＜0.05) ,while there was no significant difference between group N1 and N2(P＞0.05).Conclusions Anesthetic dose of propofol can injure spatial learning and memory ability in aged rats.Hyperlipidemia might act synergistically with propofol.

Objective To summarize the effect of venous anastomisis from left atrium-common venous anastomisis ( supracardiac anasto-mosis) at the top of left atrium,and to find the best method to treat total anomalous pulmonary venous connection ( TAPVC) . Methods 52 cases,of which 35 male and 17 female with the age of 1 month to 41 years old and the weight of 3. 1~77 kg,hospitalized in West China hos-pital from January 2000 to April 2008,were treated by supracardiac anastomosis. Results One was dead and the other 51 cases were fully recovered and left hospital. After the operation,no anastomotic stenosis or arrhythmia was observed except the dead one. During follow-up peri-od which lasted from 3 months to 12 years,the heart function of 45 cases were normal. Conclusion supracardiac anastomosis can reduce the risk of anastomotic stenosis and arrhythmia,it is a promising method to treat supracardiac type TAPVC .

The reasons why some medical treatment facilities (MTF) can not be repaired and returned on time in some medical therapy units are explained. Countermeasures are put forward: repairing and supervising mechanisms must be established between the medical therapy units and factories in time; professional maintainers can be asked to repair MTF or cooperate with technicians in hospital when necessary so as to keep MTF in good condition.

Objective:To summarize the 10 year clinical experience of treating tibiafibular fractures with rectangle shaped intramedullary nails(RIN). Methods:From January 1987 to December 1996, 4 682 cases (3 278 male and 1 404 female) of tibiafibular fractures from 9 hospitals were treated with RIN . Three kinds of reduction methods including open reduction, semi open reduction and closed reduction were used during operation. Results:Results showed 2 173 cases (62.89%) got excellent result, 947 got good (27.40%), 214 got moderate (6.19%), 121 got poor (3.50%). The total healing rate was 90.29%. Conclusion:RIN has excellent biological characteristics which can provide a flexible interfixation when treating tibiafibular fractures, and the operation is simple, it also can be used for severe open fractures. RIN is one of the good techniques in treating tibiafibular fractures.

Three-way laryngeal mask airway (tLMA) was used in 31 patients aged 4-68 yr, weighing 10- 79 kg undergoing tracheal foreign body removal under general anesthesia. Anesthesia was induced with propofol 3 mg/kg, vecuronium 0.12 mg/kg and remifentanil 0.4 μg/kg. tLMA was inserted. The patients were mechanically ventilated. Anesthesia was maintained with iv infusion of propofol 2 mg . Kg-1 ? H-1, vecuronium 0.08 mg·kg-1·h-1 and remifentanil 0.15 μg·kg-1 ·min-1 . Radial artery was cannulated for BP monitoring and blood sampling. The operation time was 6-34 min and mechanical ventilation time 19-45 min. There was no significant change in SP, DP, HR, VT, Ppeak and Ppeak CO, during operation as compared with the baseline values before anesthesia. SpO2 was significantly increased at T2-6. PCO2, PO2 and O2sat were obviously improved after tLMA was used. All the patients emerged bom anesthesia within 30 min after operation. No aspiration, obvious gastrointestinal inflation, and pharyngeal and laryngeal edema and injury occurred. Mild agitation occurred in a short time during the recovery period in one patient. No complication occurred.

BACKGROUND: Irradiation therapy in the cancer patients after surgery may have negative effects on implant fixation. OBJECTIVE: To observe the effects of 60Co irradiation and trace element zinc on fixation strengths of titanium implant. METHODS: Thirty-six adult male rabbits were involved. One piece of titanium implant was separately placed into the bilateral proximal tibial heads in rabbits to set up animal models of titanium implants. The animals were randomly divided into control group, zinc supplement group, 60Co irradiation group and 60Co irradiation and zinc supplement group. Zinc sulfate of 10 g/L was administered intramuscularly to animals in the zinc supplement group at the dose of 4 mg/kg once per day, and those in the control group were treated with saline at the same dose. The animals in the 60Co irradiation group received 60Co irradiation at the dose of 45 Gy and saline by intramuscular injection. Those in the 60Co irradiation and zinc supplement group received 60Co irradiation and zinc sulfate. The animals were killed at 1, 4 and 12 weeks after treatment. The fixation strengths were measured and compared among groups. RESULTS AND CONCLUSION: (1) Zinc supplement made the titanium implants have higher fixation strengths, and reach a high level at 4 weeks after surgery. (2) 60Co irradiation significantly inhibited the fixation strengths of the implants. After 60Co radiation, zinc supplement stil could promote fixation strengths of titanium implants. (3) It is indicated that amount of zinc supplement after irradiation therapy can al eviate the negative effects of irradiation on implant fixation.

BACKGROUNDBisphosphonates have been used to treat many bone diseases in clinic. Bisphosphonates have also been proven useful in the management of bone metastasis in patients with breast and prostate carcinoma as demonstrated in a number of trials in vitro and in vivo, but, it is little known that the effect of bisphosphonates on lung cancer, one of the most common bone metastatic malignant tumors. This study is to investigate the effect of several bisphosphonates on inhibiting proliferation of different lung cancer cell lines in vitro, and to validate whether this inhibitive effect is comprehensive or selective.

METHODSThe cytotoxic effect of bisphosphonates on lung cancer cells and human normal liver cells was determined by sulforhodamine B (SRB) assay.

RESULTSAfter incubation of lung cancer cells with bisphosphonates for 72h, the proliferation was inhibited in different degrees. The inhibiting activity of medronate (MDP) was the lowest, while the activity of ibandronate and incadronate (YM175) was between MDP and alendronate. The effects of bisphosphonates on human normal liver cells were different. The toxicity of MDP, ibandronate and YM175 was low, while alendronate had high toxicity. The sensitivity of lung cancer cells to bisphosphonates was also different. The sensitivity of H446 and SPC-A1 was comparatively lower, while H460 and A549 were more sensitive.

CONCLUSIONSBisphosphonates can inhibit the proliferation of lung cancer cells and human normal liver cells in different degrees. The inhibiting effect is associated with the kind and concentration of bisphosphonates, and also the kind of lung cancer cells.

OBJECTIVE:To establish the method for simultaneous determination of the content of berberine hydrochloride, baicalin and osthole in Jinchan zhiyang capsules. METHODS:HPLC method was adopted. The determination was performed in Hypersil BDS C18 column with mobile phase consisted of methanol-acetonitrile-0.1%phosphoric acid-three triethylamine(50∶30∶19∶1, V/V/V/V) at the flow rate of 1.0 mL/min. The detection wavelengths were set at 265 nm (berberine hydrochloride),280 nm (baicalin)and 322 nm(osthole). The column temperature was set at 30 ℃,and sample size was 10 μL. RESULTS:The linear range of berberine hydrochloride,baicalin and osthole were 80-800 ng(r＝0.999 8),60-600 ng(r＝0.999 9),60-600 ng(r＝0.999 6),respectively. RSDs of precision,stability and reproducibility tests were all lower than 2.0%. The limits of quantitation were 80,60,60 ng,respectively,and the limits of detection were 24,20,20 ng,respectively. The recovery rates were 97.4%-98.3%(RSD＝0.33%,n＝6),98.4%-99.6%(RSD＝0.42%,n＝6)and 96.9%-99.0%(RSD＝0.92%,n＝6),respectively. RSDs of durability tests were all lower than 1.2%. CONCLUSIONS:The method is simple, accurate, precise, stable, reproducible and durable. It can be used for simultaneous determination of berberine hydrochloride,baicalin and osthole in Jinchan zhiyang capsules.