Postoperative pulmonary dysfunction in patients undergoing cardiopulmonary bypass(CPB) is a significant clinical problem and has long been recognized by cardiac surgeons. The studies of the pathogenesis and protection strategies of CPB induced lung injury have been the focus in the field of cardiac surgery. This review presents the recent progress of the pathogenesis and protection strategies of lung injury following CPB.

Procalcitonin (PCT) detection is a diagnostic tool for the differential diagnosis of bacterial or non-bacterial infections complicated by a systemic inflammatory response. Recent research in the cardiac surgery with cardiopulmonary bypass (CPB)suggests PCT level reflect the systemic inflammation following CPB. Measurement of PCT may help to identify the patients with high-risk who may be benefited from specific treatment administered and intensified monitoring provided, so as to reduce the surgical complications.

Acute lung injury (ALI) is one of the most important complications after cardiopulmonary bypass (CPB) and the complex pathophysiology remains to be resolved incomplete. At present, there is no specific and uniform criterion about the diagnosis of ALI following CPB. The changes of physiology and biochemistry in the lung can indicate the development of the ALI, and give proof of the early diagnosis of ALI following CPB.

There are lots of contents in the clinical teaching of cardiothoracic surgery , but the teaching time is short .What should be concerned by every cardiothoracic surgery teacher is how to make full use of the limited time to make students grasp the main contents of cardiothoracic surgery .It is crucial to develop new models of education and assessment .We discuss efforts in our teaching , including new teaching paradigms , teaching tools and multimedia teaching .The combination of varieties of teaching methods , clinical and basic teaching , theory teaching and clinical practice may improve the quality of clinical teaching in cardiothoracic surgery .

Objective Objective Structured Clinical Examination (OSCE) is one of the most important methods for evalua-ting the medical students′clinical ability .The aim of this study was to analyze the value of OSCE on practice examination in the depart -ment of cardiothoracic surgery . Methods Through the use of standardized patients and the six-station clinical examination , we as-sessed the clinical skills of interns in the department of cardiothoracic surgery . Results OSCE could appraise interns′clinical ability objectively and accurately , which obtained the recognition from students . Conclusion OSCE is applicable to the clinical skills tes-ting in the department of cardiothoracic surgery .

The patients with dedifferentiated thyroid carcinoma were induced by all-trans retinoic acid (ATRA). The treatment was effective in 5 patients (5/9,55.6%), and 5 patients were benefited from following 131 I treatment(5/8, 62.5% ). Three patients(3/12,25.0% ) quitted because of neurological side-effects. It is efficacious to apply ATRA to induce dedifferentiated thyroid carcinoma and improve radio-iodine uptake and acquire benefit for patients, but clinic application of ATRA must be cautious.

[Abstract ] Objective The aim of the study was to investigate the effects of recombinant human erythoropoietin (EPO) and bone marrow mesenchymal stem cell (BMSC) transplantation on renal inflammatory response following cardiopulmonary bypass (CPB). Methods Forty sprague-Dawley male rats were randomly divided into five groups (n=8):shame operation group, CPB group, EPO group, BMSC group and EPO +BMSC group.CPB model was built in shame operation group without CPB .The other four groups un-derwent CPB, following by jugular vein infusion of 1.5 ×106 BMSCs after an hour′s 100 L/kg/min bypass .Jugular vein infusion of 3000 IU/kg EPO was done in EPO group , while the combination of EPO with BMSCs was infused in EPO +BMSC group.The same volume of isotonic saline solution was infused via jugular vein in CPB group and shame operation group respectively .Rats were sacrificed at 24 hours after CPB termination .Blood samples were collected for the determi-nation of creatinine(Cr) and urea nitro(BUN) levels.HE staining was applied in the examination of renal tissues .ELISA was used in the determination of serum interleukin 6 (IL-6) and interleukin 10 (IL-10) levels and western blot was taken to test the expressions of tumor necrosis factor (TNF-α) and insulin-like growth factor 1 (IGF-1). Results In CPB group, the levels of Cr, BUN, IL-6 and the expression of TNF-αwere increased, while IL-10 level and of IGF-1 expression were decreased(P<0.05).TNF-αexpression was increased while IGF-1 expression was decreased in renal tissue (P<0.05).HE staining results showed the renal injury in EPO +BM-SC group was significantly lower than those in EPO group , BMSC group and CPB group , along with the decrease in the levels of Cr , BUN, IL-6, the increase in IL-10 level(P<0.05), as well as the decline of TNF-αexpression and the rise of IGF-1 expression(P<0.05). Conclusion The combination of EPO and BMSCs which reduces renal inflammatory response following CPB has protective effects on renal injury following CPB in rats , which is better than single application of EPO or BMSCs .

Purpose To investigate the prognosis and influencing factor of hematoma complicated from ultrasonography-guided EnCor vacuum-assisted breast biopsy system in minimally invasive surgery for breast lesions, and to provide reference for clinical treatment. Materials and Methods 280 female patients with 486 benign breast lesions underwent minimally invasive excision using a ultrasonography-guided EnCor vacuum-assisted device, occurrence and the inlfuence factors of hematoma complicated from the operation was observed. Results All the 486 lesions were completely excised with EnCor system, hematoma (≥1cm) were found in 47 cases after 24 hours and almost disappeared in 6 months. After analysis of the occurrence of hematoma, it was found that the following situations would lead to a higher incidence of hematoma, which included lumps ≥ 2.5 cm, more than two lesions removed at one time, lumps locating deep inside the areola or the edge of breasts, bigger and less dense breasts, operation in menstrual period, pressure bandaging after operation less than 12 hours and operation without using adrenaline (P<0.05 or P<0.01). Conclusion Benign lesions breast can be effectively excised using ultrasonography-guided EnCor vacuum device, and the factors listed below could affect the occurance of hematoma complicated from the surgery, including the size, location and number of the resected nodules, breast shape, surgery during menstrual period, postoperative pressure bandaging and the use of hemostatics.

Objective To study the action of puerarin on Caspase-3 and Bcl-2 expression of hippocampal CA1 neurons in ovariectomized rats, and explore its mechanism. Methods SD female rats were randomly assigned into sham operation group, model group, premarin group and puerarin groups (120, 60, 30 mg/kg). The model group and sham operation group were injected NS intraperitoneally, other groups were treated with corresping drugs for 30 d. Immunohistochemistry and RT-PCR were used to determine Caspase-3 and Bcl-2 expression of hippocampal CA1 neurons. Results Caspase-3 expression of hippocampal CA1 neurons was significantly decreased in high-dose puerarin group (P <0.05). Bcl-2 expression of hippocampal CA1 neurons was significantly increased in high- and medium-dose puerarin groups (P<0.05, P<0.01). Bcl-2 mRNA level of hippocampal CA1 neurons in high-dose puerarin group was significantly increased (P<0.05). Conclusion Puerarin can decrease Caspase-3expression and increase Bcl-2 expression of hippocampal CA1 neurons in ovariectomized rats, and has protective effect on neuronal structure.

Objectives: To study the correlation between plasma matrix metalloproteinase 9(MMP 9) concentration and acute lung injury following cardiopulmonary bypass(CPB). Methods: Human plasma was obtained after informed consent from twenty patients undergoing CPB. Plasma was collected at the beginning of CPB, 5 minutes after the initiation of CPB, at the termination of CPB, 1 hour after the termination of CPB and 6 hours after the termination of CPB. All samples were analyzed by standard enzyme linked immunosorbent assay (ELISA). A aDO 2 and respiratory index (RI) was measured at the termination, 1 hour and 6 hours after termination of CPB. The cross clamp times, CPB times and the time to extubation was recorded. Data were expressed as means ?SE and assessed by analysis of variance (ANOVA).The regression analysis was utilized to define the correlations of variables measured( A aDO 2 ,RI, cross clamp times, CPB times and the time to extubation ) at the end of CPB. Results: Plasma MMP 9 concentration was significantly increased at the end of CPB (430.6?50)?g/L( P