Objective To observe the bleeding risk of short-term intensive statin therapy after coronary artery bypass grafting. Methods A total of 240 patients treated with coronary artery bypass grafting were randomly divided into group A(experimental group)and group B(control group). All pa-tients were normalized to conventional treatment and they were given low molecular weight heparin for an-ticoagulant therapy during the perioperative period. Patients in group A were given 40 mg of atorvastatin before surgery,and 40 mg of atorvastatin every night for one month after the surgery. Patients in group B were given 10 mg of atorvastatin every night during the treatment. One month after the operation,platelet aggregation rate and bleeding events of patients were compared. Results There were significant differ-ences in maximum platelet aggregation rate[(14. 5 ± 3. 7)% vs(38. 1 ± 7. 4)% ,P < 0. 05],inhibition rate of platelet aggregation[(79. 5 ± 4. 3)% vs(50. 8 ± 10. 2)% ,P < 0. 05],and incidence of postopera-tive bleeding[27. 5% vs 12. 5% ,P < 0. 05]between group A and B,respectively. Conclusion Short-term intensive statin therapy can increase the bleeding risk after coronary artery bypass grafting.

Objective To evaluate the minimally invasive techniques and myocardial protective results of open heart surgery in beating heart.Methods 138 patients underwent minimally invasive open heart surgery in beating heart under cardiopulmonary bypass (CPB) with light hypothermia,of which 58 cases underwent right anterolateral thoracotomy,35 cases had lower sternotomy and full length sternotomy was performed in 45 cases.Among 138 cases,97 cases had repairment of atrial and ventricular septal defects,8 atrioventricularis communis,18 other congenital heart disease,two left atrial myxomas,one mitral valvuloplasty and 12 mitral value replacement.Results There were no severe arrhythmia and air embolism,but only one operative death because of low cardiac output.Other patients were discharged and had no late deaths.Conclusion Minimally invasive open heart operation in beating heart is a feasible,safe and effective technique for most of the cardiac surgery.Advantages of a right anterolateral thoracotomy or lower hemisternotomy in beating heart are obvious,including a smaller incision,less injury and blood loss,quick recovery,maintenance of the integrity of the bony cage and excellent myocardial protection.It is consistent with the idea of minimally invasive surgery.

The changes of cytochrome oxidase activity of retinal ganglion cell (RGC) caused by the artificial high intraocular pressure (HIOP) was presented in this paper. Normal saline was injected into the anterior chamber of the right eye of 36 rats. that resulted in an intraocular pressure up to 60 mmHg for 3 hours. The experimental rats were divided into 0-, 3- and 7-day groups according to their survival time. Both retinae of each rat were whole mounted on the same slide, the left one being used as control. Thirty-six pairs of retina were treated with the modified cytochrome oxidase (CCO) histochemical technique under similar conditions. The high CCO activity of RGC were counted. The extinction of the cytoplasm of RGC, which indicates the degree of CCO activity, was measured with microphotometer. As compared with the normal eyes, the high CCO activity RGC of experimental eyes were reduced significantly. It was found that the high CCO activity of RGC in the temporal side of retina has been reduced much more than that of the nasal side. However, the high CCO activity of RGC in 3- and 7-day groups were more than that of 0-day group, the extinction of CCO activity of RGC in 7-day group was lower than that of the 3-day group. These facts showed that the CCO activity might restore in various degrees followed by a longer survival time. This experiment emphasized the fact that the HIOP led to metabolic changes of RGC, which may be of value to the study of glaucoma.

Ovbective To evaluate the clinical results of simultaneous enlargement of the pulmonary annulus and the pulmonary cusp with a transannular patch of autologous pericardium in right ventricular outflow tract(RVOT)reconstruction. Methods From Jan.2003 to Jan.2004,Twenty-five patients who have complex congenital heart anomalies with pulmonary artery hypoplasia received surgical correction with RVOT reconstruction were randomly divided into research group (n=13) and control group (n=12). The patients in the research group used the technique of simultaneous enlargement of the pulmonary annulus and the pulmonary cusp with a transannular patch of autologous pericardium,routine technique of a transannular patch with or without a autologus pericardial monocuspid valve was used in control group. The main clinical characteristics and follow up data were studied and compared. The degree of pulmonary insufficiency was evaluated before discharge,at 3～6 months,and at 12months after the operation. Results There was no operative mortality in two groups. Compared with control group,the mean right ventricle to left ventricle systolic pressure ratio,right atrial pressure,maximum doses of dopamine and correction of pulmonary insufficiency were improved significantly (P

Objective To study the clinical application of Compass (R) system,a novel 3D quality assurance system for the verification of esophageal carcinoma intensity-modulated radiotherapy (IMRT) plan.Methods 12 esophageal carcinoma IMRT plans were optimized with Eclipse 8.6 treatment planning system (TPS),and then Compass (R) reconstructed 3D dose distributions with the patient anatomy.Comparison was performed among the reconstructed and calculated with TPS,Dose-volume parameters (γ pass rate、average dose deviation) to the planning target volume (PTV) and critical structures were quantitative valuated.Furthermore two-dimensional dose verification were performed use MatriXX,γ pass rate were evaluated with 3％/3 mm criteria.Results The γ pass rate of actual gantry angle was found generally declined seemingly compared with 0 degree gantry angle in two dimensional verification,difference was statistically significant (P =0.018-0.001).In 3D dose verification,the γvolume of PTV were exceed 93％,the deviation of D95,D50,D2 were less than 3％;The γvolume of lungs and heart were exceed 95％,the average dose deviation were less than 3％;The γ pass rate of spinal cord and trachea were exceed 98％.The independent check verified more conformed with the TPS calculated.Dose deviations appeared in the radiation field edge area.Conclusions 3D dose verification can provide more information to comprehensively evaluate the plan which is benefit for evaluating the clinical value of verification.

[ ABSTRACT] AIM: To investigate whether L-carnitine ( LC) inhibits the eryptosis effect of uremic serum on erythrocytes.METHODS:Erythrocyte suspension (2%) was cultured and divided into 3 groups in vitro: control group ( C group) , uremic serum group ( U group, 30%uremic serum) , and uremic serum+LC group ( L group, 30%uremic serum+200 μmol/L LC) .Erythrocytes were collected at 24 h and 48 h.Eryptosis ( phosphatidylserine expression repre-sents eryptosis) was estimated by flow cytometry with Annexin V staining.The content of reactive oxygen species ( ROS) was also detected.Glutathione ( GSH) was measured by ELISA.RESULTS:Eryptosis in C group was increased as the in-cubating time extended.Eryptosis in U group was higher than that in C group, while that in L group was lower than that in U group.Meanwhile, ROS content was higher and GSH was lower in U group than those in C group.ROS content was low-er and GSH was higher in L group than those in C group.CONCLUSION:LC inhibits uremic serum-induced eryptosis by decreasing ROS and increasing GSH, thus attenuating oxidative stress.

Objective: To investigate the anti-tumor effect of Glycyrrhiza flavonoids(GF) and its immunological mechanism.Methods: Mice bearing sarcoma 180(S180) were randomized into 3 GF-treated groups and one control group.The mice in GF-treated groups were perfused with GF.Leukocyte and lymphocyte count were taken by the blood cell analyzer.Flow cytometry was performed to detect the percentages of the T cell subsets.Results: Treatment of GF resulted in the tumor inhibition rates of 52.3%(high dose group).Blood total leukocyte and lymphocyte count in GF treated groups were all higher than that in the control group,and there was the most significant increase of the number of immune cells in the high dose GF group(P

Objective To review the clinical experience of reconstruction of pulmonary artery(PA) by a pateh of autologus pericardium or azygous venae for non-small cell lung cancer. Methods Between March 1992 and August 2009, 62 patients with locally advanced central lung cancer received sleeve resection and reconstruction of PA. According to PTNM classification, 4 patients were in stage Ⅱb, 46 in stage Ⅲa and 12 in stage Ⅲb. 17 patients had induction chemothoerapy. Sleeve lotrate the PA, the surgical procedures included partial PA tangential resections and reconstructions by a pateh of autologous azygous venas in 18 cases , a patch of autologous pericardium in 38 cases and a complete PA sleeve resection reconstructios by a custom-made autologous pericardial conduit interposition in 6 cases. Partial superior vena cava tangential resctions and reconstructions were performed in 5 patients by a patch of autologous pericardium or azygous venae. 47 patients received pstoperative chemotherapy and 19 had radiotherapy. Results There was 2 early postoperative deaths(3.2%). The cause of death was bronchial anastomotic leak led to respiratory failure in 1 case and severe arrhmia led to heart arrest in 1. No cancerous tissue of all resection margins are checked by frzen section histology and examination of resection specimens in the surgical pathology laboratory. The postoperative complications occurred in 11 patients(17.7%) and all of them recovered uneventfully.Roentgenography, flexible bronchoscopy and echocardiography were in normal range in the remaining 60 patients with no bronchial anastomosis stenosis or vascular thombosis before discharge and at 2-6 months after surgery. The mean follow up time was 49.5 months (6-210 months). The overall 1, 3, 5 and 10 yerr survival rates were 80.2%, 44.7% ,31.4% and 23. 1%, respectively. Conclusion Reonstruction of PA by autologous pericardial patch or autologous azygos vein patch is a safe and effective technique for locally advanced lung cancer.For extended circumferential defects of PA,the autologous pericardial conduit interposition could bue used for reconstruction.

Objective Artificial atrial septum defect combining pulmonary artery banding to create a model of congenital heart defect with decreased pulmonary blood flow to explore the morphological changes of immature pulmonary vascular. Methods Choose twenty piglets with about one to two-month-old, which are exclusively for experiment used. The piglets were randomly divided into three groups: normal control group (group C, n = 6), Small incisions on the right chest, produced a transient reduction in pulmonary blood; low-medium pulmonary artery stenosis groups ( group T1, n = 7 ) : Did artificial room septostomy creation by self-dilators which were delivered into the surface of the right atrium and controlled Systolic trans pulmonary artery banding pressure (Trans-PABP) at pressure of 20 - 30 mmHg; severe pulmonary artery stenosis groups ( group T2, n = 7): T2 were the same surgical procedures with group T1 ,and controlled Trans-PABP ≥ 30 -50 mmHg. Monitored ultrasound after operation , carried out 64-slice computed tomography scanning after one month, to measure the proximal vessel diameter and TransPABP , after two month surgical exploration on the left chest. When the animals were sacrificed, the heart and lung tissue was cut to measure atrial septal defect, pulmonary artery and the banding diameter. By weihgt elastic fiber and van Cieson staining to observe the morphological pathological changes, three groups took lung tissue with right middle lobe lateral segment about 1.0 cm × 0.8 cm × 0.8cm at the end of surgery and 2-months after operation respectively. Results The models were all successfully in the survival animal of the two test groups. One pig died from tracheal intubation accident in the C group, there was one case died due to bowel obstruction in the T1 group, And there were two cases died result from acute right heart failure and chronic heart failure respectively in T2 group. 64-slice CT angiography showed that BD was significantly lower than the AOD in the two test groups, the proximal pulmonary vascular expansion result from stenosis, distal pulmonary vascular scarce. Histopathology showed that the pulmonary artery inside diameter of T1 and T2 was significantly higher than group C(P ＜0. 05,P ＜ 0.01), and the NAPSC of two experimental groups were significantly lower than group C 2-month after operation( P ＜0.01).Conclusion This type of Piglet model is closer to clinical pathological and physiological ,64-slice spiral CT combined with lung histopathology observed for the evaluation of pulmonary vascular hypoplasia is a reliable method. Tunica media of pulmonary arterioles hypoplasia with the number reducing, with pulmonary artery banding increased,the degree of pulmonary arterioles hypoplasia gradually increased.

Objective To explore the method of oleic acid two strike to build a better clinical pathophysiology of acute lung injury animal model state.Methods The 60 male and healthy Sprague-Dawley rats, weighing 180 ～ 220g.According to the time of purchase.No.1, 2, 3 The order No.60, Each number, were randomly divided into 3 groups: normal control group(20 rats) : intravenous injection of normal saline 0.07ml/kg, an hour after intravenous injection of saline 0.03 ml/kg.The traditional group(20 rats) : intravenous injection of oleic acid 0.l ml/kg.The model group(20 rats) : intravenous injection of oleic acid 0.07 ml/kg, one hour after intravenous injection of oleic acid 0.03 ml/kg.Close observation of vital signs of breathing and Hemodynamicsin rats.Stable operation of 30 min, Each operation is stable after 30 minutes of measuring arterial blood gas, lung water content, the change degree evaluation of early lung injury of lung tissue pathology.Through the analysis of arterial blood gas, lung water content, HE stained pathological changes of lung tissue in Smith scoring method to determine the degree of lung injury in rats, to evaluate whether the model was successfully established.Results There are 5 rats died after a sharp drop in blood pressure of oleic acid used in traditional group rats, the changes of hemodynamics of traditional group compared with model group were severe, especially in the 5 ～ 30min after injection of oleic acid.The model group was no death, intravenous injection of oleic acid(0.1 ml/kg) from 7 to 8 min after respiratory frequency rats increased gradually, difficulty in breathing, endotracheal see pink frothy sputum.After 1 h pumping and arterial blood gas results showed that pH (7.17 ± 0.15) PaO2, (41.85 ± 8.16) mmHg was significantly lower than that of normal group(P ＜ 0.01) , oxygenation index (PaO2/FiO2) ≤ 300 mmHg, met the diagnostic criteria of acute lung injury, the moisture content(P ＜ 0.05), according to the Smith score, pathological model group compared with normal group significantly increased(P ＜ 0.01).Conclusion Two hit the body can produce severe inflammatory reaction of lung and lasting, build a close clinical pathophysiology of acute lung injury animal model successfully state.Meet the pathophysiological clinical change of acute lung injury, and can be used for basic and clinical research of acute lung injury in infants.