Objective To investigate the feasibility of minimal access valve surgery. Methods The authors performed minimal access valve surgery from January 1997 to January 2003 in 72 cases: 36 cases of mitral valve operations and 9 cases of tricuspid valve operations were performed through right anterolateral thoracotomy; 5 cases of aortic valve operations through mini-sternotomy approach; 5 cases of aortic valve operations and 2 cases of mitral valve operations through para-sternotomy approach; 15 cases of mitral valve operations through “reversed L” mini-sternotomy access. Results In the early course following the surgery (within 1 postoperative month ) 71 patients survived and 1 patient died of acute hepatic and renal failure.Complete follow-up in 64 patients for 6～60 months(mean, 13 months) revealed that all the patients responded symptomatically, with New York Heart Association (NYHA) Class Ⅱ status in 56 patients and Class Ⅲ in 8 patients. Color ultrasonocardiogram revealed normal status of mechanical or biological valves. All the patients were satisfied with cosmetic results. Conclusions Minimal access valve surgery is feasible, and is also associated with a better outcome in terms of sternal stability and postoperative recovery.

Objective Annexin A3 (ANXA3) is a member of the annexin family,As the existing studies suggest,ANXA3 is closely related to tumor genesis,development,invasion,metastasis and prognosis.ANXA3 is down-regulated in prostate and kidney cancer,but it is up-regulated in breast cancer,liver cancer and other tumors.ANXA3 is related to tumor size,staging,lymphatic metastasis and prognosis.Silencing ANXA3 expression can not only inhibit the proliferation and invasion of colorectal cancer and hepatocellular carcinoma cells,but also restrain the migration of breast cancer cells.ANXA3 may also be involved in the regulation and maintenance of hepatocellular stem cells through HIF1a / Notch and JNK signaling pathways.The current studies have shown that ANXA3 can serve as a potential biological marker of tumor diagnosis,prediction of chemotherapy sensitivity,and provide a new target for oncotherapy.

Objective To compare the clinical and follow-up results of different ways of operation for the treatment of patients with hilar cholangiocarcinoma ,and to explore its e key technology and related prognosis .Methods 31 out of 50 patients with biliary and partial liver resection(control group) ,19 patients with hemihepatectomy (observation group) .Radical resection rate and surviv-al rate were compared in the two groups .Results radical resection rate control group and observation group was 35 .48% (11/31) and 68 .42% (13/19) ,the difference was statistically significant (P=0 .014);the difference of 1 ,3 ,5 year survival rates between the two groups were statistically significant (P= 0 .03) ,observation group :85 .4% ,58 .6% ,32 .2% ,control group:86 .1% ,65 .2% , 20 .0% .Conclusion Radical resection is still the most important measures the patients for cure and long-term survival ,radical re-section rate ,survival rate ,and prognosis could be improved greatly by improving operation skills and experience accumulation ,com-bined with hepatectomy .

Objective: To elucidate the possible mechanism responsible for the improved protection of terminal warm blood cardioplegia (TWBC) after hypothermic cardiopulmonary bypass (CPB) through analysis of tubulin (TB) components changes in myocardial cells exposed to TWBC. Methods: Stable animal models of CPB were established in cats, which were then randomly divided into 2 groups. Group Ⅰ was subjected to intermittent cold blood cardioplegia (ICBC) whereas group Ⅱ to ICBC followed by TWBC before uncross-clamping. Left ventricular performance was then monitored and evaluated by LVSP, LVEDP, ±dp/dtmax and t-dp/dtmax in both groups and semi-quantitive analysis was conducted with Western blot method as to the content and constitution of TB in myocardial cells at 15 min, 120 min after aortic crossclamping (ACC) and 5 min,15 min, 60 min,120 min after reperfusion. Results: Within 120 min after reperfusion, systolic and diastolic functions decreased significantly in group Ⅰ as compared with group Ⅱ(P<0.05). At 115 min after ACC and 15 min after reperfusion, the content of free and polymerized TB in both groups had no difference (P>0.05). At 120 min after ACC and 5 minutes after reperfusion, there was a significant difference between groupⅠ andⅡ (P<0.01). Conclusion: TWBC accelerates the repolymerization of myocardial TB during hypothermic CPB, which may mediate the improved cardiac performance in the early stage of myocardial reperfusion.

The effect of high-dose glucocorticoid (GC) on plasma phospholipase A2 (PLA2) activity, extravascular lung water (EVLW) and lung pathology during cardiopulmonary bypass (CPB) was studied on the CPB model in rabbits. The results showed that both plasma PLA2 activities and EVLW increased significantly during CPB, and there was a significant correlation between EVLW and plasma PLA2 activities at 90 min of CPB (r = 0. 8439, P

Intracerebral hemorrhage is a disease with high mortality and morbidity. This article discussed the application of magnetic resonance diffusion tensor imaging for intracerebral hemorrhage clinical research, and its limitations and prospect.

Objective: To evaluate the bioavallability and bioequivalence of rabeprazole sodium enteric-coated pellets capsules. Methods:A randomized crossover design was performed in 32 healthy male volunteers. A single oral dose of 20 mg rabeprazole sodium enteric-coated pellets capsules ( test preparation) or enteric-coated shell capsules ( the reference capsules) was administrated under fed conditions. The wash period was 7 days. The blood samples were collected at different time points. The concentration of rabeprazole in plasma was determined by an LC-MS/MS method. The pharmacokinetic parameters were calculated by DAS 3. 0 software and the bio-equivalence was evaluated. Results:The maln pharmacokinetic parameters of the two formulations were shown as follows:T1/2 of (2. 20 ± 0. 83)h and(1. 951 ± 0. 515)h,Tmax of (3. 88 ± 1. 11)h and(4. 64 ± 1. 504)h,Cmax of (401. 06 ± 170. 75)ng·ml-1 and(394. 63 ± 215.64)ng·ml-1,AUC0→t of (918.42 ±427.39)ng·h·ml-1 and (994.49 ±520.73)ng·h·ml-1, and AUC0→∞ of(937.30 ± 445.13)ng·h·ml-1 and(1 011.69 ±534.77)ng·h·ml-1. The analysis showed that the maln pharmacokinetic parameters of the two formulations had no significant differences(P>0. 05) except for Tmax(P<0. 05). The relative bioavallability of rabeprazole sodium enteric-coated pellets capsules was (99. 80 ± 7. 20) %. Conclusion:Compared with the reference capsules, rabeprazole sodium enter-ic-coated pellets capsules show the property of higher dispersion degree, milder influence from food, more rapid release and absorption. The enteric-coated pellets capsules and the reference capsules are bioequivalence.

Objective To investigate the imaging findings of early heterotopic ossification. Methods The imaging findings of 30 rehabilitation patients with heterotopic ossification were analyzed. Results The early heterotopic ossification performance of X-ray and CT showed articular soft tissue edema, and higher density. MR images showed different signal characteristics at different stages of heterotopic ossification. Immature bone performance the same or long T1 and T2 signal, enhanced scan showed the edge of the lace-like "strengthen". Conclusion Heterotopic ossification at different stages shows different imaging features. Magnetic resonance imaging is the best effective methods for the diagnosis of early ectopic ossification, X-ray and CT can be used for review.

BACKGROUND: Autologous vein transplantation is a common means for clinical treatment of coronary atherosclerotic heart disease. Identification of basic pathological changes of autologous vein transplantation will provide basis for further studies on how to protect transplanted vein and reduce the possibility of restenosis of transplanted vein.OBJECTIVE: This study was designed to investigate effects of hyperlipemia, an independent influential factor, on venous endothelial functions and histomorphology.DESIGN, TIME AND SETTING: This study, a randomized controlled animal experiment, was performed at the key laboratory of Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University of Chinese PLA.MATERIALS: A total of 50 healthy adult male rabbits were randomly and equally divided into a control group and a hyperlipemia group.METHODS: In the control group, rats were daily fed with normal diet 100-120 g. In the hyperlipemia group, rats were daily fed with normal diet 100-120 g plus cholesterol 1g. For all rats, water was freely available.MAIN OUTCOME MEASURES: Prior to and 2,4,8, and 12 weeks after feeding, blood sample and cervical vein specimens were taken for detection of blood lipid levels and observation of endothelial nitricoxide synthase (eNOS)expression, nitric oxide (NO) production, and histomorphologic change. Prior to harvesting vein sample, blood flow of jugular vein and carotid artery was examined using ultrasonic Doppler flowmeter. Simultaneously, histopathological changes including the thickness of intima and media, the diameter of the veins, and the presence of lipid or atherosclerotic plaque were observed.RESULTS: Eight weeks after feeding, blood lipid levels in the hyperlipemia group were significantly higher than those prior to feeding and in the control group (P<0.01), and maintained at this level. Obvious lipid plaques formed in the carotid artery of rabbits in the hyperlipemia group. Eight and twelve weeks after feeding, eNOS expression levels and NO production in the jugular veins were lower than those prior to feeding and in the control group (P<0.05). Simultaneously, endothelial denudation was noticed and the elastic fibers almost disappeared in the hyperlipemia group; there were no foam cells or lipid plaques.CONCLUSION: Hyperlipemia may result in endothelium dysfunction and histomorphological change of venous conduit.Nevertheless, autogenous vein transplanted into artery system, will greatly influence the remodeling of transplanted vein,even lead to restenosis of transplanted vein.

Objective To investigate the feasibility and accuracy of enhanced magnetic resonance pulmonary perfusion imaging(MRPP) in the diagnosis and follow-up of pulmonary embolism(PE). Methods Sixty patients suspected of PE underwent MRPP. Twenty-seven patients also underwent radionuclide perfusion imaging. 22 patients repeated MRPP examination after 3 day to 1 month anticoagulation or thrombolytic therapy. The feasibility and accuracy of MRPP in the diagnosis and follow-up of PE were evaluated according to the transformation rate of signal (TROS), time-signal curve and some parameters of main pulmonary artery(such as peak value of flow,mean flow velocity and flow rate). The t test and rank sum test were used for the statistics. Results MRPP showed a high agreement with radionuclide perfusion imaging. TROS was (2. 86 ± 2. 48 ) vs ( 6. 72 ± 2. 54) ( t = 3. 370, P ＜ 0. 01 ), the peak time was ( 13.98 ±5.60) vs ( 12. 33 ± 3.63 ) s ( t = 3. 930, P ＜ 0. 01 ), the peak value of main pulmonary blood flow was (60.39 ± 15. 17) vs (69.93±13.22) cm/s(t=2.930, P＜0. 01) and mean flow velocity (11.68±5.46) vs ( 13.54 ± 4. 18 ) cm/s ( t = 2. 380, P ＜ 0. 05 ) before and after anticoagulation or thrombolytic therapy. The flow rate per unit was (80. 57 ± 24. 87) vs ( 85.48 ± 11.81 ) ml/s ( t = 0. 86,P ＞ 0. 05 ) . Conclusion MRPP shows a high agreement with radionuclide perfusion imaging and is a useful method for the diagnosis and follow-up of PE.