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.

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 detect the expression of integrin ?5?1 in restenosed human vein grafts.Methods The expression of integrin ?5?1 and ?-smooth muscle actin(?-SMA) in 30 resected restenosed human vein grafts(from Kerfuff clinical hospital of Germany) was detected by confocal immunofluorescence with specific antibodies against ?5?1 and ?-SMA.Images were processed with Silicon Graphics Octane.Results In normal veins,integrin ?5?1 expression was very weak in media smooth muscle cells and in endothelium,and ?-SMA expression was present in media smooth muscle cells.In the restenosed vein grafts,integrin ?5?1 was strongly stained in the media smooth muscle cells and intimal endothelial cells,and moderately in the intimal smooth muscle cells,?-SMA was present in media smooth muscle cells and in the intimal smooth muscle cells.Conclusion Our research reveals that integrin ?5?1 is significantly upregulated in the media smooth muscle cells and intimal endothelial cells in the restenosed human vein grafts,suggesting the participation of integrin ?5?1 in the restenosis formation of human vein grafts.

Objective To improve the establishment of severe acute pancreatitis model in rat. Methods 36 Sprague-Dawley rats were randomly divided into experiment or shame operation group(n=18,each). Severe acute pancreatitis was induced by injection of 4% sodium taurocholate through puncturing common bile duct with a fine needle, puncture hole was closed by medical sealant glue. Ascites volume and blood amylase were measured at 3, 6 and 12 hours after injection. Gross and histological changes of pancreas were evaluated by a scoring system. Results Pancreatic changes in the experiment group was hemorrhagic and necrosis.The ascites volume(8.52±1.05)ml,serum amylase activity(5247.17±547.07)u/L, gross and histological scores(13.6±3.92) in experiment group was significantly higher than ascites volume(1.21±0.32)ml,serum amylase activity(1289.5±176.67)u/L, gross and histological scores((0.83±0.58) in shame operation group at every time point(P<0.05). Conclusions Combined injection through common bile duct and medical sealant glue in the experiment can minimize the trauma and simplize the procedure. This method produces a reliable model with high success rate and it is an ideal severe acute pancreatitis animal model.

Objective To explore the effects of glutamine (Gln) on tumor necrosis factor-alpha (TNF-α),interleukin-6(IL-6),and interleukin-10 (IL-10) in rats with severe acute pancreatitis (SAP).Methods 54 Sprague-Dawley rats were randomly divided into 3 groups ( n =18 for each group):Gln treatment group ( Gln),SAP model group (SAP),and negative control group (NC).SAP was induced by injection of 4％ sodium taurocholate through common bile duct with a fine needle and the puncture hole in the bile duct was closed by medical sealant glue.Sham operation was performed in the rats of NC group.Rats in Gln group received Gln injection and rats in SAP group and NC group received normal saline instead of Gln.Ascites volume and blood amylase were measured at 3,6 and 12 hours after injection and plasma cytokines were detected by enzyme-linked immunosorbent assay (ELISA).Gross and histological changes of pancreas were evaluated by a scoring system.Results The ascites volume,serum amylase level,gross and histological scores,TNF-α level,and IL-6 level were significantly higher in SAP group than in NC group at each time point(P＜0.05).IL-10 level was significantly higher in SAP group than in NC group at 3 hour point(P＜0.05).The ascites volume,serum amylase level,and gross and histological scores were significantly lower in Gln group than in SAP group at the time point of 3 hour and 6 hour after injection( P ＜ 0.05 ).Level of TNF-α and IL-6 was significantly lower in Gln group than in SAP group at each time point( P ＜0.05 ).IL-10 level was lower in Gln group than in SAP group at 3 hour point( P ＜0.05 ).Conclusion Gln is effective in SAP treatment by decreasing the serum level of proinflammatory cytokine and ameliorating the pathological damage of pancreatic tissues in rats.

Objective To investigate the protective effect of resveratrol on ultraviolet A (UVA)-irradiated human fibroblasts and its mechanism.Methods Fibroblasts were isolated from normal human foreskin and subjected to primary culture and four passages of subculture.Then,some fibroblasts were incubated with various concentrations (0.01,0.1,0.5 and 1.0 mmol/L) of resveratrol for 6,24,48 and 72 hours separately,followed by methyl thiazolyl tetrazolium (MTT) assay for the evaluation of cell proliferation.Some fibroblasts were classified into four groups:blank control group remaining untreated,UVA group irradiated with UVA only,0.01 and 0.1 mmol/L resveratrol groups receiving UVA irradiation immediately followed by treatment with resveratrol of 0.01 and 0.1 mmol/L respectively.The dose of UVA irradiation was consistently 10 J/cm2 in these groups.After additional culture for 6,24,48 and 72 hours,MTT assay was conducted to evaluate cell proliferation,enzyme-linked immunosorbent assay (ELISA) to measure the levels of interleukin (IL)-1α,IL-1β,and IL-6 in the culture supernatant.Results Resveratrol at 0.5 and 1.0 mmol/L significantly inhibited the proliferation of fibroblasts,with the strongest inhibitory effect observed at 72 hours when the cell survival rate was 31.99％ ± 8.29％ and 21.15％ ± 5.76％,respectively.After irradiation with UVA of 10 J/cm2,the survival rate of fibroblasts was 78.01％ ± 12.74％ at 6 hours and 80.64％ ± 36.12％ at 72 hours,compared to 100.04％ ± 10.78％ and 99.95％ ± 12.23％ in the blank control group respectively (both P ＜ 0.05); the supernatant levels of IL-1α,IL-1β and IL-6 were significantly increased compared with the blank control group at 6 hours ((58.39 ± 0.67) vs.(48.51 ± 6.20) ng/L,(1294.37 ± 92.51) vs.(1023.25 ± 86.40) pg/L,(197.81 ± 6.37) vs.(160.45 ± 7.19) ng/L,all P ＜ 0.05),and the increase still existed at 72 hours for IL-1β ((1236.76 ± 56.49) vs.(1045.55 ± 48.14) pg/L,P＜ 0.05) and IL-6 ((215.65 ± 3.78) vs.(195.09 ± 1.78) ng/L,P ＜ 0.05).Compared with the UVA group,the 0.01 mmol/L resveratrol group showed significantly higher survival rates at all the four time points (all P ＜ 0.05),but lower supernatant levels of IL-1α at 6,24 and 48 ((43.89 ± 3.60) vs.(51.77 ± 1.77) ng/L,P＜ 0.05) hours as well as IL-lβ and IL-6 at all the four time points (all P ＜ 0.05),while the 0.1 mmol/L resveratrol group experienced no significant changes in cell survival rate at any of the time points,with a significant decrease only in the supernatant level of IL-6 at 6 and 24 ((182.90 ± 6.67) vs.(240.62 ± 1.42) ng/L,P ＜ 0.05) hours.In detail,the survival rate of fibroblasts was 91.93％ ± 12.90％,with the supernatant level being (1110.12 ± 51.91) pg/L for IL-1β and (201.94 ± 4.71) ng/L for IL-6 at 72 hours in the 0.01 mmol/L resveratrol group,compared to 80.64％ ± 36.12％,(1236.76 ± 56.49) pg/L and (215.65 ± 3.78) ng/L respectively in the UVA group (all P＜ 0.05).Conclusion Resveratrol at 0.01 mmol/L has a protective effect on UVA-irradiated fibroblasts,likely by inhibiting the secretion of IL-1α,IL-1β and IL-6.

Objective To investigate the efficacy of uterine artery chemoembolization in the treatment of locally advanced cervical cancer.Methods A total of 268 patients with locally advanced cervical cancer were treated with uterine artery chemoembolization in our department.The stage distribution among the patients included 132 stage Ⅰ B2,85 stage Ⅱ A1 and 51 stage Ⅱ A2.There were 223 patients of squamous cell carcinoma,24 patients of adenocarcinoma,9 patients of adenosquamous carcinoma,small cell carcinoma of the 7 patients,5 patients of neuroendocrine carcinoma.Transcatheter uterine artery infusion of paclitaxel and nedaplatin,gelatin sponge particles was applied for uterine artery embolization.The clinicopathological parameters were analyzed,and their impacts on tumor response were investigated.RECIST criteria were used to evaluate the response in solid tumors.Student t test was used to compare cervical tumor diameter before and after treatment,and Chi-square test was used for comparison of categorical data.Follow up examinations included pelvic ultrasound,gynecology,vaginal stump cell smears.Results Of the 268 patients,74 (27.6％) patients showed a complete response,160 (59.7％) patients had a partial response to uterine artery chemoembolization,and the overall response rate was 87.3％.A total of 258 (96.3 ％) patients underwent surgery,and pathological complete response were identified in 46 (17.2％).Forty (14.9％) patients were found to have lymph node metastasis after surgery.Response rates of stage Ⅰ B2 and Ⅱ A cases were 94.7％ and 80.1％,respectively,P ＜ 0.05.Patients with squamous cell carcinoma showed a better response rate than patents with other pathological types (94.2％ vs.53.3％),P ＜ 0.05.Initial tumor volume and cycles of preoperative uterine artery chemoembolization had no effect onthe response rate.Conclusions Uterine artery chemoembolization can increase the rate of surgical resectionof patients with locally advanced cervical cancer and can improve the reaction rate with tolerable side effect.It is an applicable option of treatment for patients with locally advanced cervical cancer in the neoadjuvanttreatment.

Objective To compare the efficacy and side-effects of preoperative neoadjuvant uterine arterial chemoembolization and venous chemotherapy in treating cervical cancer in young female patients. Methods A total of 241 young females(≤35 years old) with cervical cancer were enrolled in this study. The clinical data were retrospectively analyzed. The patients were divided into group A (n=63) and group B (n=57). Patients in group A received preoperative neoadjuvant uterine arterial chemoembolization with subsequent surgery, while patients in group B were treated with preoperative neoadjuvant intravenous chemotherapy followed by surgery. The chemotherapy scheme included carboplatin (50 mg/m2) and gemcitabine (1 000 mg/m2). The short-term effect, the amount of blood loss during the surgery, pathological findings and the side-effects of the two groups were compared. The Kaplan-Meier method was used to calculate survival rate, and the log-rank test was used for survival difference analysis. Results The short-term response rate of group A was 90.5%, which was significantly higher than that of group B (71.9%), the difference between the two groups was statistically significant (χ2=7.5, P<0.05). The resection rate of group A was 95.2%, which was higher than that of group B (84.2%). The amount of intra-operative blood loss of group A and group B was (443±263) ml and (695±312) ml respectively, the difference was statistically significant (t=4.802, P<0.05). The pathological complete remission of group A and group B was 9.5%(6/63) and 5.3%(3/57)respectively; the differences in postoperative pathological results between the two groups were statistically significant (χ2=12.3, P<0.05). The side effect of group A was milder than that of group B (P<0.05). The 5-year progression-free survival (PFS) rate of group A and group B was 73.0% and 54.4% respectively (χ2=4.471, P<0.05);and the overall survival (OS) rate of group A and group B was 77.8%and 63.2%respectively (χ2=3.022, P>0.05). In both groups, the clinical stage, the pathological grade and the size (≥ 4 cm) of the tumor were the main factors that could influence the prognosis in young females with cervical cancer (P<0.05). Conclusion The short-term efficacy of preoperative uterine artery chemoembolization is better than that of preoperative intravenous chemotherapy for the treatment of cervical cancer in young female patients. Besides, this therapy carries mild side effect, and it can improve the 5-year progression-free survival rate, although the long-term survival rate has not been obviously improved.

Objective To investigate the clinical therapeutic effect of comprehensive treatment in young women with cervical car-cinoma.Methods A total of 52 young women with cervical carcinoma were treated with uterine artery chemoembolization.50 cases underwent radical hysterectomy and pelvic lymphadenectomy after interventional therapy.The patients with pathological risk factors were given supplementary radiotherapy.Results The clinical overall response rate was 88.5%.96.2% of patients underwent sur-gery and lymph node metastasis rate was 26.9%.The 2,5 year overall survival rates of patients were 91.5%,71.2% respectively. Conclusion The comprehensive treatment can improve overall survival rate and quality of life for young woman with cervical carci-noma.Postoperative patients with pathologically related risk factors should be treated with supplement chemoradiotherapy.

OBJECTIVE: To explore the effects of Salvia miltiorrhiza on renal morphology and renal function of rats with streptozotocin diabetes. METHODS: Thirty male Wistar rats were randomly divided into three groups, which were normal control group, untreated group and Salvia miltiorrhiza-treated group. Diabetic nephropathy was induced in rats of the last two groups by intraperitoneal injection of streptozotocin after unilateral nephrectomy. Then the rats in the normal control and untreated groups were fed with normal saline while those in the Salvia miltiorrhiza-treated group were fed Salvia miltiorrhiza preparation for 8 weeks. The glomerular volume (VG), kidney-to-body weight ratio (KW/BW), urinary albumin excretion rate (UAER) and creatinine clearance (Ccr) were observed. The expression levels of transforming growth factor-beta1 (TGF-beta1), connective tissue growth factor (CTGF), fibronectin (FN) and plasminogen activator inhibitor-1 (PAI-1) were detected by real-time quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) at the end of the experiment. RESULTS: UAER, Ccr, VG and KW/BW ratio were significantly higher in the untreated group than those in the normal control group (P<0.05). The expression levels of TGF-beta1, CTGF, PAI-1 and FN in the untreated group were also significantly higher as compared with those in the normal control group (P<0.05). UAER, Ccr, VG, KW/BW ratio and the levels of TGF-beta1, CTGF, PAI-1 and FN in the Salvia miltiorrhiza-treated group were obviously lower than those in the untreated group (P<0.05). CONCLUSION: Salvia miltiorrhiza can protect rats with streptozotocin diabetes from diabetic nephropathy by suppressing the over-expressions of TGF-beta1, CTGF, PAI-1 and FN in renal cortex.