Objective To evaluate 99Tcm-MIBI imaging in patients with hyperparathyroidism and its correlation with serum intact PTH level. Methods Seventy patients with suspicious hyperparathyroidism underwent 99Tcm-MIBI imaging and serum intact PTH measurement. Abnormal increased uptake lesion appeared at early phase and even more clearly at delayed phase was considered as the positive by 99Tcm-MIBI imaging. A cut-off value of PTH ＞ 88 ng/L was taken as the criteria for hyperparathyroidism diagnosis. The diagnostic efficacy of 99Tcm-MIBI imaging combined with serum PTH measurement was assessed according to post-surgical histopathology or clinical follow-up. For those operated patients, Pearson correlation coefficient between serum PTH and the gland volume was calculated. Results Hyperparathyroidism was confirmed in 38 patients by histopathology (n = 36) or follow-up (n = 2). The overall diagnostic accuracy of 99Tcm-MIBI imaging was 90.0% (63/70), in which the accuracy was 80.0% (12/15) for patients with normal serum PTH and 92.7% (51/55) for those with elevated serum PTH. False positive 99Tcm-MIBI imaging were found in 3 patients with normal serum PTH. The diagnostic accuracy of abnormally high serum PTH combined with 99Tcm-MIBI imaging was 94.3% (66/70). There was a positive correlation between serum PTH level and the volume of pathologic parathyroid glands (r = 0.782, P ＜ 0.001 ). Conclusions Serum PTH measurement may help to improve the diagnostic accuracy of 99Tcm-MIBI imaging in patients with hyperparathyroidism.

Formula granule of traditional Chinese medicine (TCM) has been characterized as a safe medication with the advantages of accurate dosage and easy to carry.In this study,references over current status of the development of TCM formula granule were retrieved,so were those of the market situation and its application to intelligent pharmacy of TCM.Then the key problems restricting the development of the application of TCM granules were discussed,in hope of providing a reference for the development and its application to the intelligent pharmacy of TCM.

Objective To summarize the surgical experience gained from robotic mitral valve replacement (MVR), and demonstrate the long-term clinical follow-up results. Methods From Jan. 2007 to Jan. 2015, more than 700 patients underwent various types of robotic cardiac surgery in the Department the authors served in, and of them 43 patients underwent robotic MVR with da Vinci Surgical System (Intuitive Surgical, USA). Among the 43 patients, the average age was 47±11 years (ranged 19-65 years), and sex ratio (female to male) was 0.8:1. Six patients were with heart function of NYHA class Ⅰ, 30 patients were of NYHA class Ⅱ and 7 patients were of NYHA class Ⅲ. The left ventricular ejection fraction (LVEF) were 54%-78% (64.0%±7.1%), and 20 patients had atrial fibrillation on admission, and 35 patients were with rheumatic mitral stenosis (MS). Atrial septal defect (0.7cm in size) co-existed in 1 case and 1 patient had mild aortic regurgitation. Mechanical or bioprosthetic mitral valve was replaced via left atriotomy by using da Vinci robotic surgical system after cardiopulmonary bypass (CPB) set-up. Radiopaque titan clips was employed by Cor-Knot knot-tying device (LSI Solutions, Inc, Victor, NY) to anchor the prosthetic valve. Trans-esophageal echocardiography (TEE) was performed before and after surgery. The operative data were collected and patients were followed up at outpatient clinic regularly up to 6 years. Results All cases were performed successfully with the same surgery. No conversion to median sternotomy or operative mortality occurred. The average operation time was 292±62 minutes (ranged 140-450 minutes) with CPB time of 124±26 minutes and aortic occlusion time of 88±21 minutes. The postoperative mechanical ventilation support time was continued for 15±6 hours, and the average staying length in critical care unit was 4±1 days. No myocardial infarction, ventricular tachycardia or excessive bleeding was complicated. All patients were successfully followed up for a median of 3.5 years (ranged 1 month to 6 years). In the follow-up period, no incidence of death, stroke, re-operation due to prosthetic endocarditis or prosthetic failure was reported. However, 39.5% (n=17) patients still had atrial fibrillation after surgery. Conclusion Robotic MVR is a safe and effective procedure with excellent long term surgical outcome.

Objective To investigate if the administration of CORM-2 can provide protection against renal ischemia-reperfusion injury (IRI).Method Murine renal ischemia was induced by clamping left renal pedicles for 40 min with vascular micro damps at 32 C,then the contralateral kidney was removed.CORM-2 or vehicle was administered via intravenous infusion 1 h before the onset of ischemia.The blood plasma and renal samples were obtained at 24 h after reperfusion to assess renal function and cellular injury.Plasma Cr and BUN levels,HE and TUNEL were performed to estimate the magnitude of renal damage.Kidneys were retrieved from indicated animals at various time points after renal IRI,and the sections were prepared for histological evaluation.MPO staining procedures were performed to assess the neutrophils infiltration in the renal IRI.Besides,Immunofluorescent stain of TNF-α was performed on the kidneys which were retrieved from indicated animals to determine the production of inflammatory mediators in renal I/R.Results The plasma Cr and BUN were significantly increased at 24 h after reperfusion in IRI control mice,and CORM-2 treatment could markedly diminish the increase of plasma Cr and BUN in mice subjected to I/R.In parallel,histological analysis demonstrated that CORM2 treatment markedly reduced apoptosis of the renal tubular epithelium cells and hemorrhage.IRI caused marked infiltration and accumulation of the MPO-positive neutrophils in renal interstitium.Administration of CORM-2 before ischemia dramatically inhibited neutrophils infiltration as compared with IRI or iCORM-2 group.Furthermore,we confirmed that CORM-2 markedly decreased production of TNF-α.Conclusion Carbon monoxidereleasing molecule CORM-2 could ameliorate inflammation to protect against the renal IRI in mice.

Brain Abscess ; surgery ; Epilepsy ; etiology ; Humans ; Kidney Failure, Chronic ; complications ; Male ; Middle Aged ; Recurrence

Objective Subject To summary the port placement and system set-up for robotic minimally invasive heart surgery using da Vinci S system in China. Methods 400 patients accepted selective robotic minimally invasive heart surgery from January 2007 to January 2011. We conducted a retrospective review of port placement and system set-up for all the surgeries. During the surgery 3-4 ports were made in the lateral thoracic wall and the position of ports were modulated according to the types of diseases, the procedure and patients' habitus. The surgeon completed the procedure before the surgeon console.The arms of da Vinci S system was adjusted according to surgery procedure. Results The right lateral ports were suitable for the intracardiac operation with extracorporeal circulation. And the left lateral ports can be used in the inner thoracic artery harvesting and coronary bypass graft on beating heart. Except for 1 case changed to sternotomy because of sever pleural adhesions,no arms collision and mechanical malfunction during the surgery that leaded to surgical conversion. Conclusion Robotic minimally invasive heart surgery can be safely applied to partial cardiac surgeries. The port position and system set-up should be adjusted according to the habitus of patients and surgical requirement.

Objective Summary the first group of robotic bypass surgery on the beating heart and stent placement in distinct hybrid session in China. Methods 163 cases patients accepted selective operation of robotic coronary bypass grafting on the beating heart form April 2007 to January 2011. 12 cases had multi coronary vessels stenosis accepted stent placement after robotic surgery in a hybrid manner. The average age of patients was ( 56. 0 ± 9.74 ) years old. 3 case was female and 9 cases were male. All the patients had a medical history of angina. The coronary arterioangiography showed sever left anterior descend ing or diagonal branch stenosis in all patients. And 4 cases had myocardial infarction history. All the patients had good lung function and had no medical history of pleurisy. Without sternotomy, through 3 ports about 1 cm in left thorax, the left internal mammary artery was obtained and simultaneously single vessel coronary artery bypass grafting through small thoracotomy or totally endoscopic coronary bypass (TECAB) was performed on beating heart. The bridge patency and revascularization was accessed by arterioangiography. Results All cases successfully accepted robotic bypass surgery on the beating heart and stent placement in distinct hybrid session without complication. Conclusion Hybrid coronary artery revascularization enable adequate revascularization of patients with multivessel coronary artery disease without sternotomy and with the advantage of the most durable option.

Objective As the first robotic da Vinci S surgical system(Intuitive Surgical,Inc,CA) in China,atrial septal de- fect repair(ASD) were performed in 15 patients using the robotic da Vinci S surgical system.Prespectively,we evaluated safety and efficacy in performing both simple and complex ASD repairs.Methods Eligible patients had ASD with mild to moderate pulmonary hypertension.Operative techniques included peripheral cardiopulmanary perfusion,a 2 cm working port only in the forth intercostal space,transthoracic aortic occlusion,and antegrade blood cardioplegia.Transesophageal echocardiograms(TEE) were done intraoper- atively with three-dimensienal reconstructions.Successful repairs were defined.Results Enhanced three-dimensional visualization of ASD allowed safe,dexterous intracardiac tissue manipulation.All patients had successful repairs including direct suturing in 10 cases, as well as pericardial patching in 5 cases.There were no operative deaths,strokes,or device-related complications.One patient was reexplored for bleeding.There were no incisional conversions.The mean cardiopulmonary bypass times and aortic crossclamp times were (109.5?12.6) minutes and (41.2?11.7) minutes.Both robotic repair and total operating times decreased significantly re- spectively.Total ICU length of stay for patients was 1 to 2 days.Conclusion This study shows that the da Vinci S surgical system (intuitive Surgical,lnc) has no limitations in performing ASD repairs.Articulated wrist-like instruments and three-dimensional visual- ization enabled precise tissue telemanipulation.

OBJECTIVE: To seek a exact method of estimating postmortem interval (PMI). METHODS: This study detected the concentration of magnesium (Mg) and iron (Fe) in vitreous humor of rabbit at 96 h after death and explored the relationship between their concentration and PMI using a method ICP-MS. RESULTS: The concentra-tion of Mg in vitreous humor of rabbit at 48 h after death and Fe in vitreous humor of rabbit at 6-48 h after death were related to PMI significantly. The formulae of the relationship between PMI and Mg concentrations is y = 0.0738x2 + 0.6997x + 11.45 (within 48 h, R2 = 0.9119). The formulae of the relationship between PMI and Fe concentrations is y = 0.0411x2 - 0.3148x + 1.4113 (within 6-48 h, R2 = 0.9594). CONCLUSION The concentration of Mg in vitreous humor of rabbit at 48 h after death and Fe in vitreous humor of rabbit at 6-48 h after death may be as reference indicator to estimate PMI.
Animals ; Iron/analysis* ; Magnesium/analysis* ; Mass Spectrometry/methods* ; Postmortem Changes ; Rabbits ; Time Factors ; Vitreous Body/chemistry*

OBJECTIVETo investigate the feasibility of prevention and treatment of early scar through observing the effect of feeding immunosuppressive drug cyclophosphamide on rabbit ears hypertrophic scar tissue in early stage.

METHODSThirty-two Rabbit ears were used to establish animal models for hypertrophic scar and randomly divided into four groups: group of distilled water (A), group of cyclophosphamide 5 mg x kg(-1) x d(-1) (B), group of 10 mg x kg(-1) x d(-1) (C), group of 30 mg x kg(-1) x d(-1) (D). Before animal models were built and after administration for 14 days, 28 days, leukocytes and lymphocytes were detected. After 28 days, specimens were harvested and underwent HE staining and VG staining in order to assess HI, NA, AA value changes. The data (HI, NA, AA) from each group were compared by analysis of variance, and the variance for the rank sum test when missing.

RESULTSOn the 14th day, the number of leukocytes in group A, B, C, D were (8.62 +/- 0.58) x 10(9)/L, (4.48 +/- 0.41) x 10(9)/L, (2.7 +/- 0.26) x 10(9)/L, (1.33 +/- 0.27) x 10(9)/L; the number of lymphocytes in group A, B, C, D were (3.11 +/- 0.21) x 10(9)/L, (1.67 +/- 0.16) x 10(9)/L, (0.42 +/- 0.10) x 10(9)/L, (0.40 +/- 0.09) x 10(9)/L. On the 28th day, the number of leukocytes in group A, B, C, D was (8.63 +/- 0.53) x 10(9)/L, (5.10 +/- 0.27) x 10(9)/L, (3.10 +/- 0.26) x 10(9)/L, (1.98 +/- 0.20) x 10(9)/L; the number of lymphocytes A, B, C, D was (3.06 +/- 0.16) x 10(9)/L, (2.08 +/- 0.14) x 10(9)/L, (0.96 +/- 0.19) x 10(9)/L, (0.14 +/- 0.07) x 10(9)/L. On the 14th day and 28th day, the number of leukocytes and lymphocytes in experimental groups was reduced, showing a negative relation with cyclophosphamide dose (P < 0.05). The HI in group of A, B, C, D was 3.02 +/- 0.24, 2.59 +/- 0.43, 2.06 +/- 0.19, 1.63 +/- 0.11; the AA was 40.49 +/- 2. 07, 35.29 +/- 1.99, 28.36 +/- 1.87, 24.99 +/- 1.82; the NA was 4570.5 +/- 259.3, 4222.5 +/- 199.6, 3540.3 +/- 170.3, 3341.4 +/- 228.8. The difference in HI, AA, NA between control group and any of the experimental groups was statistically significant (P < 0.01). Each group, with the dose increased, except NA content of group C and D, the HI, AA, NA was more smaller, negative correlation, the difference was statistically significant (P < 0.05).

CONCLUSIONSFeeding cyclophosphamide can inhibit leukocytes and lymphocytes number, so as to inhibit the proliferative activity of hypertrophic scar. It has significant effect on prevention of hypertrophic scar on rabbit ears in early stage.

Animals ; Cicatrix, Hypertrophic ; drug therapy ; prevention & control ; Cyclophosphamide ; pharmacology ; Ear ; pathology ; Female ; Leukocyte Count ; Leukocytes ; drug effects ; Lymphocyte Count ; Lymphocytes ; drug effects ; Male ; Rabbits