Objective To search the way of prolonging xenograft survival of discordant cardiac xenotransplantation.Methods All animals were divided into groups A,B,C and D receiving the following combined therapies respectively:cobra venom factor (CVF) in group A,CVF and pentoxifylline (FTX) in group B,CVF and CCS (CsA,CTX,MP)in group C,CVF,PTX and CCS in group D.The recipients were given CVF 150 μg/kg(i.P) twice daily 1,4 days before transplantation;PTX 50 mg/kg daily(i.P)1 h before transplamtation,then 25 mg/kg(i.P)in an interval of 6 h until rejection thereafter;CsA 10mg/kg(i.p) daily one day and 1 h before transplantation until rejection;CTX 40 mg/kg(i.p) one day before transplantation,then 10 mg/kg(i.P)daily 1 h before transplantation until rejection thereafter;MP 10 mg/kg(i.v)1 h before transplantation,then 1 mg/kg(i.m) daily until rejection thereafter.The expression of vascular cell adhesion molecular-1 (VCAM-1) of vascular endothelial cells (EC) in cardiac xenografts was detected by using immunohistochemical staining method.Results The mean survival time of cardiac xenografts was 57.5 h (group A),77.38 h(group B),79.13 h (group C) and 98.75 h(group D),respectively.Twenty-four h after transplantation.VCAM-1 expression in the groups B and D was not upregulated,but slightly up-regulated in group C and obvious in group A.At rejection,the up-regulation of VCAM-1 expression was mildest in group D and most obvious in group A.and VCAM-1 expression in group B was milder than that in group C (P＜0.05).Conclusions CVF combined with PTX and CCS could significantly prolong the survival time of cardiac xenograft.PTX mainly protected EC and CCS mainly inhibit inflammatory cell infiltration.Combined use of them could complement and reinforce mutually.

Objective: To study the effects of ulinastatin (UTI) on lung function after cardiopulmonary bypass. Methods: 60 patients, ASA score II～III, scheduled for elective cardiac valvular replacement, were randomly allocated into three groups. Study group (group I, n=20), UTI 10?000 U/kg group (group II, n=20), and UTI 20?000 U/kg group (group III, n=20). OI, V_D/V_T, P(A-a)O_2, CaO_2 , SaO_2 and PaO_2 were studied respectively. Ventilation time, simultaneous breath frequency within 24 hours after extubation and respiratory changes were also observed. Results: Compared with pre-CPB, in group I, postoperative OI, V_D/V_T, P_ (A-a) O_2 increased and CaO_2, SaO_2, PaO_2 decreased, respectively (P

Objective To study the effects of CO2 pneumope ritoneum on the abdominal viscera metastasis and peritoneal implantation of gastric cancer cell line MKN45 during laparoscopic gastric surgery.Methods The gastric cancer cells metastatic model was eslhblished by injecting 1 ml(2×107/ml)human gastric cancer cell line MKN45 susDension into the caecum wall of 60 Balb/C mice.Two weeks later,the Balb/C mice were divided into CO2 pneumoperitoneum group(n=30)and laparotomy group(n=30). All mice were sacrificed 7 weeks later to investigate the abdominal viscera metastasis and peritoneal implantation of gastric cancer cells.Results Twenty-seven rats in CO2 pneumoperitoneum group were induced with tumor,including 8 with troear port implantation and 19 with organ metastasis;26 rats in laparotomy group were induced with tumor,including 7 with tracar port implantation and 19 with abdominal viscera metastasis,and the differences between the two groups had no statistical significance(x2=0.007,0.240,0.202,0.106,0.042,P＞0.05).Conclusions CO2 pneumoperitoneum does not stimulate the metastasis of gastric cancer(cells to peritoneum and abdominal viscera in Balb/C mice.Laparoscopic surgery for gastric cancer is safe and feasible.

Advanced gastric cancer is usually dealt with D2 radical dissection. There are different opinions as to whether it is necessary to perform D3 radical lymphadenectomy.Some scholars thought that properly enlarged radical dissection can improve long-term outcomes for the treatment of advanced gastric cancer.In recent years,laparoscopic D1 and D2 radical dissection of gastric cancer could be carried out in many hospitals.However,the technique and related skills for performing D3 radical lymphadeneetomy through laparoscope remains to be explored.Based on our previous experiences,D3 radical lymphadeneetomy using artery suspension method and medial-to-lateral approach for advanced gastric cancer is proved to be safe and feasihle.

objective To compare cardiac function early after cardiac valve replacement with and without atrial fibrillation radiofrequency ablation(RFA).Methods Thirty-eight patients who underwent RFA Cox-Maze Ⅳ procedure combined with rheumatic valve replacement were discharged as cured from March 2007 to August 2009 (RFA group). Their postoperative recovery time, troponin T (cTnT) and ultrasonic cardiogram data were compared with those of 38 patients with atrial fibrillation matchad for age,sex, preoperative NYHA class and types of rheumatic valve replacement (control group). Results Although the cardiopulmonary bypass time and aortic cross-clamping time of RFA group were longer [( 152.8 ± 46.1 ),(91.0 ± 26.1 ) min] than those of control group [( 104.7 ± 40.8), (68.0 ± 30.3) min] (P ＜ 0.01 ), the postoperative recovery time and perioperative changes of LVEF of both groups were similar. Compared with control group, the RFA group's postoperative elevated cTnT was more marked [( 1.8 ± 0.6) μ g/L vs.(0.8 ±0.4) μg/L],their left atrial diameters was generally decreased (P＜0.05). Among them who underwent combined aortic and mitral valve replacement had increased posterior wall thickness of left ventricle and decreased fractional shortening. Conclusions Compared to patients having simple valve replacement, those undergoing valve replacement with RFA Cox-Maze Ⅳ procedure have generally better recovery of cardiac function early after operation, may have more potential threaten, and more attention should be paied to their perioperative myocardial preservation and preventive maintenance of cardiac function.

Objective To discuss the timing of extubation in patients of congenital heart disease (CHD)with severe pulmonary hypertension (PH) undergoing connective surgery with cardiopulmonary bypass(CPB).Methods A retrospective study of 40 patients of CHD with severe PH Was completed.According to whether the duration of mechanical ventilation (MV)>24 hours,patients were divided into two groups,early extubafion group(19 patients) and late extubation group(21 patients).Perioperative variables that might influence duration of MV were compared between the two groups.Multivariate statistical analysis with Logistic regression was used for these patients to analyze the perioperative variables to determine risk factors for prolonged MV (MV≥72 hours).Results Between the two groups,preoperative NYHA class,Pp/Ps at the time of coming off bypass,CPB duration,and CPB temperature were significantly different (P<0.05 or<0.01).Anofic spell (OR=0.022,95%CI0.001-0.580)and severe hypoxemia(OR=0.031,95%CI0.002-0.568)in the early postoperative period were the risk factors for prolonged MV.Conclusions The timing of extubation in these patients should be determined individually.Late extubation may fit those with advanced NYHA class,high Pp/Ps at the time of coming off bypass,prolonged CPB duration,or hypothermic cardiography and pulmonary artery catheter monitoring help to guide treatment for pwlonged MV.For else patients who with postoperative stable cardiopulmonary function,early extubation maybe feasible.

Objective To investigate the value of remnant stomach-jejunal dual pathways reconstruction after laparoscope-assisted radical proximal gastrectomy in the treatment of upper gastric cancer. Methods Twenty-five patients with upper gastric cancer underwent laparoscope-assisted radical proximal gastrectomy and the remnant distal stomach was preserved for side-to-side remnant stomach-jejunal anastomosis and end-to-side jejuno-jejunal anastomosis to reconstruct dual pathways. Results The mean operation time was (240±35) minutes, the mean number of lymph nodes dissected were 22±5, and all the incised margins were negative. No anastomotic leakage, obstruction or stenosis occurred. All patients received postoperative barium meal examination. A large amount of barium directly entered the jejunum, leaving a small amount of barium entered the jejunnum via the route of remnant stomach-duodenum, and was detained in the remnant stomach for 30-60 minutes. No esophageal reflux of barium was observed. All the patients were followed up for 4-18 months, no reflux esophagitis was detected and the short-term life quality was satisfactory. Conclusions Remnant stomach-jejunal dual pathways reconstruction prevents the reflux esophagitis and dumping syndrome, preserves the pathway of duodenum and promotes the life quality of patients.

Objective To investigate the feasibility,method and result of laparoscopic total gastrectomy for gastric cancer. Methods Clinical data of 63 cases of gastric cancer treated with laparoseopic total gastrectomy were analyzed retrospectively. Results In this study,52 cases underwent laparoseopic radical total gastrectomy and 5 cases did laparoseopic palliative total gastrectomy.The procedure Was hand assisted in tlle first 45 cases for fashoning esophagojejunostomy through a small incision.In six cases the procedure was converted to open surgery.The operative time was(312±35)min,the blood loss was(190±50)ml,the number of lymph nodes dissected Was(32±7).It began to pass flatus(4.0±1.2)days postoperatively.It was(4.5±1.5)days to start oral liquids.Patients were up and about on(4.0±1.5)days postoperatively. Minor postoperative complications occurred in 5 cases. Conclusion Laparoscopic total gastrectomy for gastric cancer is safe,feasible,less traumatic and of fast postoperative recovery.

AIM: To observe the relationship between the immune deviation of Th1 and Th2 cell clones and class Ⅱ major histocompatibility complex (MHC) antigen expression in different stages of acute rejection in transplanted hearts. METHODS: Heart transplantation were performed in rats.Isografts and non-transplanted animals were used as control group. Donor class II MHC antigen expression were detected with monoclonal antibodies and immunostaining technique and the amount of type Ⅰ and Ⅱ cytokines mRNA expression were detected by semiquantitative RT-PCR in cardiac allografts. RESULTS: Myocardial IL-2 mRNA and donor class Ⅱ MHC antigen expression were significantly in creased, accompanied with development of acute rejection( P

Objective:To construct a scientific and technological evaluation system based on the needs of the pilot program for building a national high-quality hospital and establishing a national medical center.Methods:Xiangya Hospital of Central South University gradually improved its academic evaluation system by following the guidelines outlined in national authorities′ documents regarding "abolishing the five only" and "setting new standards", adhering to the guiding principles of "quality, contribution, efficiency, and impact" and employing the principles of "high-standard evaluation, quantitative evaluation, representative work evaluation, and third-party evaluation" .Results:The hospital established a comprehensive, scientific, and quantifiable indicator pool. These indicators were applied to various aspects of medical innovation evaluation, including awarding incentives, discipline assessment, professional promotion, personnel assessment, mentor selection for graduates, and excellence evaluation. Simultaneously, the hospital developed an intelligent platform for medical innovation evaluation and assessment in university-affiliated hospitals based on performance management theory.Conclusions:Through the construction and practice of the Xiangya technology evaluation system, the hospital further improved and optimized its academic evaluation work, guiding researchers to high-quality innovation and efficient translational research, ultimately promoting the high-quality development of the hospital.