Objective To evaluated clinical effects and effectiveness of dual-port video-assisted thoracic surgery(VATS)for secondary spontaneous pneumothorax.Methods The clinical data of 48 pa-tients with secondary spontaneous pneumothorax who underwent open thoracotomy(n =18)or dual-port VATS(n =30)were reviewed retrospectively.Mean operation time,mean postoperative drainage period and mean postoperative hospital stay between the two groups were compared.Results All surgeries were suc-cessfully performed without reoperation and severe complications.No patient was converted to thoracotomy in the VATS group.There were significant differences in mean operation time [(67.9 ±7.2)min vs (73.3 ±6.4)min],mean postoperative drainage period [(3.2 ±0.9)d vs(5.0 ±1.3)d],and mean postoperative hospital stay [(7.2 ±1.4)d vs(8.7 ±1.5)d]between the dual-port VATS and open thora-cotomy(P <0.05 ).Conclusion Dual-port video-assisted thoracic surgery can reduce postoperative drainage period and postoperative hospital stay and increase satisfaction.It has little influence on upper limb movement and improves postoperative recovery.

Adenosine receptor agonists can activate adenosine receptors A 1 and A 3, thus trigger delayed preconditioning signal pathway and induce high expression of protective proteins and some ionic channel opening in myocardial cells, which reduces myocardial ischemia/reperfusion injury.

Artery aneurysm occurred in the aortic arch involving branches of vital organs is the difficulty of the endovascular repair.In recent years,experts have made a few researches,and have obtained some effects. We reviewed the present situation this technique in this paper.

Thoracic aortic dissection was a catastrophic disease with change quickly,and the characteristic of thoracic aortic dissection was acute onset,complex,progress rapidly,difficult to diagnosis,and highly misdiagnosis rate.So the fatality rate of thoracic aortic dissection was high,which easy caused medical disputes.Even so,the cause of the formation of thoracic aortic dissection in detail is not clear,and many risk factors associated with the occurrence of thoracic aortic dissection.These including high blood pressure,gender (male),aortic normal aging,drug using,atherosclerosis,genetic disease and inflammatory diseases,etc.

Objective To study the potential improvement of donor heart storage by A1 adenosine receptor-induced delayed preconditioning and the mechanism.Methods Male Wistar rats were randomly divided into 8 groups. Group A was pretreated with 2-chloro-N6-cyclopen-tyladenosine (CCPA),and 24 h later,the hearts were stored in St.Thomas solution for 4 h at 4 ℃ and reperfused with K-H buffer for 1 h,while group B was only injected with vehicle of CCPA. Similarly,group C was administered with CCPA,and 24 h later,subjected to 3 h of hypothermial ischemia and 1 h reperfusion,while groups D,E,F received antisense ODN (AS),sense ODN and scrambled ODN to the initiation site of rat Mn-SOD mRNA before preconditioning with CCPA,respectively. In the meantime,groups G and H were only administered with AS or vehicle of CCPA,respectively. Left ventricular function,myocardial CK-mb leakage,tissue levels of adenosine triphosphate and Mn-SOD were measured.Results The recovery percentage of ?dp/dt max of left ventricle in groups A,C,E and F were much higher than in groups B,D,G and H ( P

Objective To study the feasibility of additive improvement of heart protection by preconditioning with MLA and adenosine.Methods Rabbits of group A were injected with MLA, then 24?h later the hearts were isolated, mounted on a Langendorff apparatus, preconditioned with adenosine, perfused with filtered modified Krebs-Henseleit(K-H) buffer through left atria, instrumented left ventricular function monitor system and paced ventricularly at 180 beat/min. Hearts were arrested with 4?℃ modified St.Thomas solution, stored for 4?h at 4?℃ in this solution, and reperfused with K-H buffer. Left ventricular function, myocardial CK-mb leakage and tissue levels of adenosine triphosphate were measured. Groups B and C were only preconditioned with MLA or adenosine, respectively, while group D was only preserved with the modified St.Thomas solution in 4?℃.Results The left ventricular function recovery as percentage (+dp/dt max) in groups A, B, C was 70.97 ? 17.92 , 65.54 ? 22.62 , 64.36 ? 16.10 , respectively. If compared with group D ( 39.07 ? 13.78 ), the differences were significant ( P

Objective To discuss the feasibility of open heart operation on beating in the congenital heart diseases.Method This kind of operation was put to use in 181 cases of the congenitalheart diseases in order to observe the effects of myocardial protection, prevention from air embolism,et al.Results Operation field exposure was clear enough to finish the manipulation. All but one case was uneventiful postoperatively,especially without air embolism. Conclusion Open heart operation on beating with slight hypothermia is highly feasible in the common congenital heart diseases.

Objective To summarize the clinical experience of video-assisted thoracoscopic surgery (VATS) for thoracic diseases. Methods Clinical data of 207 patients receiving VATS form October 1997 to March 2004 were retrospectively analyzed. Among them, there were 155 cases of spontaneous pneumothorax treated by pulmonary bubble ligation or resection, 30 cases of spontaneous or traumatic hemopneumothorax treated by urgent exploration, 14 cases of pulmonary benign diseases undergoing pulmonary wedge resection and biopsy, and 8 cases of mediastinal tumor resection. Results Surgical procedures were completed thoracoscopically in 190 patients and were accomplished under thoracoscope with an additional mini-thoracotomy in 12 patients, while conversions to open surgery were required in 5 patients. The time of surgical procedures was 20~180 min (mean, 56 min). The postoperative hospital stay was 5~52 d (mean, 9 d). Postoperative complications occurred in 17 cases (8.2%, 17/207), including 9 cases of persistent air leakage, 6 cases of re-expansion pulmonary edema, and 2 cases of infection of thoracic cavity. Spontaneous pneumothorax reoccurred in 2 patients 3~4 months postoperatively. Conclusions VATS offers more advantages over traditional thoracotomy for the treatment of spontaneous pneumothorax pulmonary bubble, traumatic hemopneumothorax and selected chest benign diseases. The combination with mini-thoracotomy under certain circumstance may contribute to assuring the safety of this procedure.

Objective: To investigate the feasibility for reconstructing an aortic arch by a new integrated two-branched stent graft releasing in experimental canine thoracic aorta simulation system.
Methods: A new type of integrated two-branched stent graft was developed and placed in the canine thoracic aorta, the stent graft releasing in a simulated system was conducted under X-ray guidance to monitor the operating process and to explore the feasibility for invitro sent graft releasing.
Results: The new two-branched stent graft was successfully deployed in canine thoracic aorta simulation system. The releasing process was smooth, two small stent grafts were well landing, and all stent grafts were fully expanded and properly positioned.
Conclusion: Our new two-branched stent graft could successfully reconstruct the aortic arch in experimental canine. The thoracic aorta releasing system may better and truly simulate the whole process of endovascular aortic repairing, which provides a good foundation for further animal experiments.

OBJECTIVE:To investigate the effect of clinical pharmacist intervention on prophylactic application of antibiotics in cardiothoracic surgery. METHODS:Medical records of patients underwent cardiothoracic surgery were collected from our hospi-tal during Mar. to Apr. in 2014 (before intervention) and during Jun. to Jul. in 2014 (after intervention). Those were divided into pre-intervention group(n=115)and post-intervention group(n=119). The prophylactic application effect of antibiotics was com-pared before and after intervention. RESULTS:After intervention,the rates of prophylactic application were decreased significantly from 96.5% to 72.3%;the rationality rate of antibiotics selection was improved significantly from 27.9% to 94.2%;The course of prophylactic medication decreased significantly from(5.4±2.8)days to(2.3±1.8)days;the difference had statistical significance before and after intervention(P<0.01). The postoperative infection rate was decreased from 13.0% to 5.9%,the difference had no statistical significance(P=0.074). The average hospitalization time,average drug costs,and average hospitalization expenses were decreased significantly,the difference had statistical significance(P<0.05 or P<0.01). CONCLUSIONS:Clinical pharmacist inter-vention to prophylactic application of antibiotics in cardiothoracic surgery can control the infection effective and guarantee reason-able and safe use of drugs during perioperative period.