So far,thoracoscopy(video-assisted thoracic surgery) has been maturely used in the field of thoracic and cardiovascular surgery,and already has achieved satisfactory results.In compare,the developing cardioscopy technique to perform intracardiac surgery,due to its own characteristics,was rarely applied as an supplementary clinical means over a long period of time.But more and more studies suggested that cardioscopy technique has it's own advantages in cardiovascular surgery,such as not extend the operation time and aortic clamping time,can provide a clearer operative field,and cause less tissue damage.Although there are a few cases reported completely cardioscopy technique treatment experience,it has not been widely used in clinical because of it's limitations.Even no such kind of research has been reported in China yet.This article aims to review the status of cardioscopy technique and its development prospects,to investigate the feasibility of its'widely clinical application in the future

Objective To determine the effects of Sodium Nitroprusside ( SNP) , superoxide dismutase ( SOD) and catalase ( CAT ) on the expression of catalytic subunit of the DNA-dependent protein kinase ( DNA-PKcs ) and Ku70/80 heterodimer in cardiomycyte H9C2, as well as their expression in the myocardial tissues of SD rats . Methods H9C2 cells were co-cultured with SNP at concentreations of 10, 20 and 40 mmol/L for 6 hours, SD rats were injected with normal saline , SNP, SNP+SOD, SNP+CAT or SNP+SOD+CAT.Western blot and immuno-histochemistry assay were used to examine DNA-PKcs and Ku70/80 protein expression respectively .Results The expression of DNA-PKcs and Ku70/80 increased in H9C2 cells co-cultured with SNP when compared with control group, but they were be decreased when treated with SOD or/and CAT.The expression of DNA-Pkcs and Ku70/80 in myocardial tissues of experimental groups were higher than the control .Conclusions Radical scavengers may play a role as a protective effect for sodium nitroprusside related injury in cardiac myocytes .

Objective To study the changes of nitric oxide synthase in placenta during fetal cardiac bypass. Methods Eight pregnant ewes (gestation 120～140 d)were divided equally into control group and bypass group. Bypass group underwent fetal cardiac bypass with centrifugal pump and placenta. Fetal hemodynamic date and blood gas value were recorded before and after bypass. Placenta vascular resistance was calculated. Fetal serum nitric oxide (NO), serum endothlin-1(ET-1) and nitric oxide synthase (NOS) of placenta tissue were assayed. Transcriptions of endothelial NOSmRNA in placental tissue were assayed with RT-PCR technique. Results Acidosis and pressure of oxygen decreased after bypass appeared in fetal lamb of bypass group. Placenta vascular resistance of bypass group elevated significantly (P

Objective To evaluate effects of maternal hypothermic cardiopulmonary bypass on fetal homodynamic and carbohydrate metabolism. Methods Twenty pregnant sheep were divided into four groups randomly: control group(n=5),normothermic group (35-36℃)(n=5), mild hypothermic group(32-34℃)(n=5) and moderate hypothermic group (28-31℃)(n=5).Thoracotomy was performed without CPB in the control group. Routine CPB was established with different temperature in other three groups. The temperature of normothermic group was kept normal; the left two groups were cooled down to the set point of temperature and then rewarmed back to normal level. Fetal and maternal temperatures, heart rate,mean blood pressure(BP), pulse index (PI) of fetal umbilical artery (UA) and internal carotid artery (CA) were evaluated at cooling and rewarming stages. Biochemical indicators including blood glucose and lactic acid were also measured at the same time. Results There are no differences in mesn BP of ewas and fetal lambs between the different groups (P＞0.05). CA PI value of mild hypothermic group and moderate hypothermic group were significantly higher than those of control group and normothermic group (P＜0.05). There was no difference of UA PI in the four groups, but PI increased following the prolonged duration of CPB. There was no difference change of blood glucose in the four group of fetus, which was significantly lower than the ewe groups. An upward trend of fetal blood lactic acid with time was observed in three CPB groups. The whole level of fetal blood lactic acid was much higher than that of maternal blood of lactic acid. Conclusion Cooling of maternal bypsss decreases fetal heart rate significantly,and fetal heart rate recovered to base line following rewarming phase. There was no signicant effect of CPB on fetal mean BP. However, CPB impacted on the blood flow of fetal brain and umbilical artey. Hypothermia CPB can increase fetal blood glucose and blood lactic acid dramatically.

Objective To study the clearance of high risk human papillomavirus(HPV)infection among the women with normal cervical pathologic diagnosis.Methods One hundred and seventy.two HPV-positive cases with normal cervical pathologic diagnosis were enrolled in the study.The infection status of HPV was monitored during follow-up from Aug 2006 to Aug 2008.The time of HPV infection spontaneous clearance,as well as effect factors,were analyzed.Results During follow-up,there were 62.2%(107 cases,107/172) of the HPV infection cleared.The medium clearance time was 11.3 months(95% CI:10.6-16.6 months).The medium clearance time of aged<30 years,30-39 years,40-49 years and>49 years were 11.3,12.0,10.9 and 8.5 months.respectively.There were not significant difference among aged intervals (P=0.384).The virus copies of HPV-clearance cases and persistent-infection were 22.6 and 95.0,respectively.There was not significant difference between groups(P=0.061).Conclusions Most of the high risk HPV infection with normal cervical pathologic diagnosis would spontaneously cleared.Age and HPV copies may play little role in the HPV clearance.

Objective To summarize primary experiences of integrated fetal diagnosis and postnatal treatment for the transposition of the great arteries (TGA). Methods Five fetus were diagnozed as TGA at(28.4 ±4.4) weeks of gestation via fetal echocardiography. The mean age of the pregnant women was (28.4 ±3.0) years old. Delivers were taken by caesarean at (36.5 ±1.8) weeks of gestation. The body weight of neonates was (2468 ±442) grams. All neonates were transported to the department of neonatology and re-checked by echocardiography. 3 cases were TGA with intact ventricular septum, 2 cases were TGA with ventricular septal defect. Prostaglandin and mechanical ventilation were applied if oxygen saturation was lower. The standard arterial switch procedure was performed under cardiopulmonary bypass with moderate hypothermia. Results The mean age for patients at surgery was (9. 0 ±6. 2) days ( ranged 2-19 days). Three neonates survived, 2 preterm neonates died. One with body weight 1770 g, 2 days after operation was died of sudden heart arrest and failure of resuscitation. Another was treated by mechanical ventilation and prostaglandin after delivery and underwent operation at the second postnatal day, the neonate appeared low cardiac output and high serum lactate postoperatively and died in the third day. Conclusion The integrated fetal diagnosis and postnatal treatment for TGA could prevent severe cyanosis and emergency transportation after parturition. The lack of any link in the cooperation among the multidisciplinary team could affect the benefits for the TGA neonates provided by prenatal diagnosis.

Objective To explore the effects of delivery classification scale for fetal cardiac disease on the prenatal and postnatal integrated treatment strategies.Methods Delivery classification scale for fetal cardiac disease included:grade Ⅰ,no hemodynamics instability; grade Ⅱ,ducted-dependent lesions,stable hemodynamics anticipated;grade Ⅲ,possibility or likelihood of hemodynamic instability; IMPACT(delivery immediately heart intervention) level,hemodynamic instability is anticipated at separation from placental circulation.During August 2006 to May 2010,a retrospective study of 46 cases of prenatal diagnosis of congenital heart disease and delivery in one cardiac center was taken,in which 33 in grade Ⅰ,9 in grade Ⅱ,4 in grade Ⅲ,and no IMPACT.Results Thirty-nine boys and 7 girls were born at (38.0 ± 1.4) weeks of gestation and had consistent fetal diagnoses of mainly cardiac abnormalities with postnatal screen.Thirteen neonates underwent cardiac intervention within one week after birth with one death,including 2 in grade Ⅰ,7 in grade Ⅱ,4 in grade Ⅲ,of them 1 death.Seven infants including 5 in grade Ⅰ and 2 in grade Ⅱ underwent cardiac intervention with one death.The remaining 26 children in grade Ⅰ had uneventfully outcomes,in which 7 cases of surgical operation,17 cases of interventional therapy,2 cases of spontaneous healing.Conclusion Delivery classification scale for fetal cardiac disease should have some guiding significance for early treatment strategies and could enhance closely integration of prenatal diagnosis and postnatal treatment.The most fetuses in grade Ⅰ need not undergo cardiac interventions in neonatal stage.However,early cardiac intervention for fetuses in grade Ⅱ and Ⅲ should be carried out postnatally with the help of neonatologists.

OBJECTIVE: To evaluate the quality of reports published in recent 10 years in China about quantitative analysis of syndrome differentiation for diabetes mellitus (DM) in order to explore the methodological problems in these reports and find possible solutions. METHODS: The main medical literature databases in China were searched. Thirty-one articles were included and evaluated by the principles of clinical epidemiology. RESULTS: There were many mistakes and deficiencies in these articles, such as clinical trial designs, diagnosis criteria for DM, standards of syndrome differentiation of DM, case inclusive and exclusive criteria, sample size and estimation, data comparability and statistical methods. CONCLUSION: It is necessary and important to improve the quality of reports concerning quantitative analysis of syndrome differentiation of DM in light of the principles of clinical epidemiology.

Objective The present study was designed to investigate changes in serum or plasma concentrations of nitric oxide and its derivatives in diabetic patients.Methods Serum nitrate concentration of 84 diabetic patients was measured by using an enzyme kinetic method,and the plasma S-nitrosothiols concentration of 10 cases was measured by using HPLC technique.Results Serum nitrate concentration and plasma S-nitrosothiols concentration in the diabetics were significantly higher than in control group (P＜0.01 andP＜0.05,respectively).The serum nitrate concentration in diabetics also had a significant positive correlation with the serum glucose concentration (R=0.7256,P＜0.05),but this correlation was not found in control group.Conclusion These data showed that NO and its derivatives are overproduced in the diabetic patients.(J Geriatr Cardiol 2008;5:25-27)