Combining the PBL teaching method and the organ system as the core teaching method, we have carried on the teaching practice of 2 comprehensive experiments in the circulation system of hem-orrhagic shock and treatment, as well as the renal function and failure of the urinary system. The implemen-tation process has been divided into two links: preparation before class and class-room practice to improve the students' ability to study and solve the problem of scientific research.

Objective To observe the operative effects of coronary artery fistula. Methods Malformations and operative results of 23 cases with coronary artery fistula were retrospectively analyzed. Results There were 13 cases of fistula of right coronary artery, 9 cases of fistula of left coronary artery, one cases of fistula of two coronary artery; 9 cases of coronary artery fistula opened into right ventricle,6 cases opened into right atrium, 3 cases opened into pulmonary artery, 2 cases opened into the sinus of coronary veins, 2 cases opened into left atrium, 2 cases opened into left ventricle, 3 cases were multiple fistulas. All cases received surgical treatment, excepttion for one cases of multiple fistulas had small residue fistula, the others were better. Conclusion At pressent,the operation treatment is the best method for fistula of coronary artery .

Objective To observe the operative outcomes of Marfan's syndrome.Methods Collecting 32 cases of Marfan's syndrome operated in our hospital and analyzing the changes of cardiac function between preoperation and 6～12 months postoperation. Results There were 29 cases of Bentall(replacement of the ascending aortic with flap valve canal) operation, 3 cases of them were Bentall with total aortic arch replacement; two case were replaced the mitral valve in the homochronous operation; 3 cases died from the Bentall operation,other 3 cases were lost to follow up. The size of left ventricle(LV), left ventricular ejection fraction(LVEF), left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index(LVESVI) were remarkable improved in postoperation. Conclusions Surgical treatment is an effective way for the cardiovascular lesions of Marfan's syndrome.

OBJECTIVE:To explore the effects of Xuesaitong injection on related indexes of patients with acute ST segment el-evation myocardial infarction(STEMI)before percutaneous coronary intervention(PCI). METHODS:112 STEMI patients under-went PCI were analyzed retrospectively and divided into control group (48 cases) and observation group (64 cases) according to different treatment methods. Control group was given Clopidogrel sulfate tablets 300 mg and Aspirin enteric-coated tablets 300 mg orally before PCI;given conventional treatment according to patients'condition after surgery. Observation group additionally re-ceived intravenous push of Xuesaitong injection 8 mL before surgery,and Xuesaitong injection 8 mL added into Sodium chloride 250 mL intravenously,once a day after surgery,on the basis of control group. Treatment course of 2 groups lasted for 14 d. TIMI level,MPG level,the serum levels of cTnT,CKMB were observed in 2 groups before surgery,24 h after surgery;serum level of PTX-3,hs-CRP were observed before surgery,one week after surgery;LVEF,LVEDD,serum level of BNP were observed before surgery and one month after surgery;the occurrence of ADR was observed to. RESULTS:Before surgery,there was no statistical significance in TIMI level,MPG level,the serum levels of cTnT,CKMB,PTX-3 and hs-CRP,LVEF,LVEDD,serum level of BNP between 2 groups (P>0.05). 24 h after surgery,TIMI level and MPG level of 2 groups were significantly higher than be-fore,and the observation group was significantly higher than the control group;the serum levels of cTnT and CKMB in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,with statistical sig-nificance(P<0.05). One week after surgery,the serum levels of PTX-3 and hs-CRP in 2 groups were significantly lower than be-fore surgery,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). One month after surgery,the level of LVEF in 2 groups were significantly higher than before surgery,and the observation group was significantly higher than the control group;LVEDD and se-rum level of BNP in 2 groups were significantly lower than be-fore surgery,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Based on convention-al treatment,Xuesaitong injection can effectively improve myocardial blood supply before PCI,decrease the level of inflammatory factor,relieve myocardial injury,improve cardiac function without increasing the incidence of ADR.

Objective This research is to assess the heterozygosity of Tbx1 gene on 22q11 2 in the patients with conotruncal heart malformation.Methods By fluorescence in situ hybridization (FISH) with partial segment of Tbx1 gene, we examined 22 patients with conotruncal heart malformation including 5 syndromic cases and 17 isolated cases. Northern blot was performed with RNA of 50 human tissues.Results Two of 5 syndromic patients had chromosome 22q11 2 hemizygote microdeletion of the Tbx1 gene, while 17 isolated patients did not show such deletion. Northern blot showed that there were Tbx1 gene positive expression in skeletal muscle, testis, lung and fetal heart.Conclusions Our study suggests that Tbx1 gene may be one of the pathogenic gene related to CATCH22.Association of the Tbx1 gene and conotruncal heart teratogenic gene is to be further detected in gene mutation of patients without heterozygosity deletion.

Objective To establish the expression of exogenous tissue plasminogen activator (TPA) gene in human umbilical vein endotheliocytes to provide both theoretical basis and new method for gene therapy of ischemic heart disease and prevention of postoperative vessel re-stenosis. Methods Expression vector pcDNA3 1(+)TPA was constructed, and transfected into human umbilical vein endotheliocytes cultivated in vitro by lyposome. The exogenous TPA expression was observed. Results The expression vector pcDNA3 1(+)TPA could efficaciously express TPA in human umbilical vein endotheliocytes. The protein quantity of TPA in the transfected cells was 568 6ng/10 6cell/24h, when measured by enzyme-linked immunosorbent assay, while that in the non-transfected cells was 17 8ng/10 6 cell/24h. The exogenous TPA's activity in the transfected cells was 108 8IU/10 6cell/24h, when measured by chromogenic substrate assay, while that in the non-transfected cells was 5 6 IU/10 6cell/24h. Conclusion When pcDNA3 1(+)TPA was transfected into human umbilical vein endotheliocytes, exogenous TPA could be expressed efficaciously, which provides theoretical basis and new method for TPA gene therapy of ischemic heart disease.

Objective To investigate intraoperative neural monitoring(IONM)for prevention of recurrent laryngeal nerve injury(RLN)during thyroid cancer operation.Methods 288 cases of thyroid cancer admitted from Jun.2011 to Jun.2013 in our hospital were studied and they were divided into the observation group(140 cases) and the control group(148 cases) according to whether IONM was used during surgery.The incidence of RLN injury was compared between the 2 groups.Results The injury rate of RLN was lower in the observation group(0.67％) than in the control group(3.57％)and the operation time is shorter than the latter(P ＜0.001).There was no statistical difference for the operative bleeding volume and the average hospitalization time between the 2 groups (P ＞ 0.05).Conclusion INOM can help to shorten the operation time and reduce the incidence of RLN injury.

Objective: To study the results of surgical treatment for double outlet ventricle. Methods: The results of 72 cases of double outlet ventricle were retrospectively analyzed. Results: There were 71 cases of double outlet right ventricle, including 64 cases of type SDD, 3 type ILL, 3 type SDL, 1 type IDD. Only one case was double outlet left ventricle type ILD. Surgical procedures included left ventricle-aorta intraventricular tunnel connection in 61 patients, total cava-pulmonary artery connection in 2, left ventricle-aorta intraventricular tunnel and right ventricle-pulmonary artery extracardial tube repaired in 3. Six cases underwent bi-directional Glenn procedure. Two cases died from operation. Residue shunt of VSD was observed in one case and re-operation was done to repair the shunt. There were no long-term death and other complications. Conclusion: It is important to choose the right time and proper procedure. Reconstruction left and right ventricle is the essential factor to the surgical success.

Designed experiment in medical functional experiment has become an important way to promote creative thinking and innovation of medical students.We applied different modes of designed experiment in undergraduates of clinical medicine and basic medicine in capital medical university,including classroom designed experiments,proposition designed experiments and free proposition designed experiments.After above reforming implements,creative thinking and innovation ability of medical students were enhanced.It also provided new ideas in future teaching reform in functional experiment.