ObjectiveTo investigate the preventive effect of drugs imitating the ischemic preconditio ning to the donor lung.MethodsAdenosine was used to imitate the early protection of ischemic preconditioning, SOD to imitate the delayed protection and both of them to imitate the integral p rocess of ischemic preconditioning. At the same time, a control group was set up . The rabbits' lungs were flushed, the heart-lung blocs harvested, and adenosin e, SOD, both or none of them wadded respectively. After preservation for 6 h, th e lungs were reperfused for 1 h with the isolated rabbit lung reperfusion model. The PaO 2, airway pressure, pulmonary compliance, wet/dry ratio and content of NOS were measured. The microscopic and electron microscopic examinations were c arried out.ResultsPaO 2 values were the highest in the control group, followed by the SOD group, the adenosine group, the combined use group. The differences among the groups we re significant. The wet/dry ratio was the highest in the control group, followed by the adenosine group, the SOD group, the combined use group with the differen ces among the groups being significant. The airway pressure and NOS content in t he imitating ischemic preconditioning groups was lower than that of the control group. The pulmonary compliance of the imitating ischemic preconditioning groups was higher than that of the control group. However, the differences were not si gnificant. The microscopic and electron microscopic examination revealed that th e pathological changes in the imitating ischemic preconditioning groups was obvi ously lightened as compared with those in the control group.ConclusionsAdministration of the drugs imitating ischemic preconditioning could improve pul monary oxygenation function and ameliorate pulmonary edema. Although the drugs s howed less effect in ameliorating airway pressure, pulmonary compliance and NOS activity, the imitating ischemic preconditioning could protect the donor lung.

OBJECTIVE:To investigate the effect of preoperative use of high-dose simvastatin on the pulmonary artery pres-sure in congenital heart disease with left-to-right shunt. METHODS:86 patients with left-to-right shunt congenital heart disease who were planned to implement interventional occlusion therapy were randomly divided into control group(43 cases)and observa-tion group(43 cases). Patients in both groups were given digitalis,diuretics,anticoagulants and other basic treatments;On this basis, control group received Sildenafil citrate tablet,25 mg,3 times a day,orally given 1 h before a meal;observation group received Simvastatin tablet 80 mg,once every evening,orally. The treatment course for both groups was 7 d. Mean pulmonary hypertension (mPAP),N terminal prohormone brain natriuretic peptide (NT-proBNP),arterial oxygen saturation (SaO2),arterial oxygen ten-sion(PaO2),pulmonary blood circulation ratio(Qq/Qs),pulmonary pressure variation(Rp/Rs),pulmonary vascular resistance in-dex(PVRi)before and after treatment in 2 groups were observed,and related indicators of liver functions [alanine aminotransfer-ase (ALT),aspartate aminotransferase(AST)] and myocardial enzymes [lactate dehydrogenase (LDH),creatine kinase MB(CK-MB)] were detected. The incidence of adverse reactions were deteted. RESULTS:Before treatment,there were no significant differ-ences in mPAP,NT-proBNP,SaO2,PaO2,Qq/Qs,Rp/Rs,PVRi,ALT,AST,LDH and CKMB levels in 2 groups(P>0.05). Af-ter treatment,mPAP,NT-proBNP,Rp/Rs and PVRi levels were significantly lower than before,SaO2,PaO2,and Qq/Qs levels were significantly higher than before and Qq/Qs level in observation group was higher than these in control group.The difference was statistically significant(P<0.05). There was 1 patient showed severe liver injury in observation group and exited the test;the other 85 patients showed no obvious adverse reactions,with successful surgery and good prognosis. CONCLUSIONS:The preoper-ative use of high-dose simvastatin shows obvious effect on controlling mean pulmonary hypertension,reducing mPAP,NT-proB-NP,Rp/Rs and PVRi levels and increasing SaO2,PaO2,and Qq/Qs levels before operation,with good safety.

Objective To assess the safety of combined lung resection and cardiac surgery in patients with synchronously occurring lung tumor and heart disease. Methods Fourteen patients with synchronously lung tumor and heart disease received lung resection combined with open heart surgery between 2003 and 2008 in our hospital. There were 11 men and 3 women with a mean age of 64 years. Lung resection consisted of lobectomy in 8 patients, sleeve lobectomy in 1, and wedge resection in 5.Pulmonary tumor pathology was squamous cell in 4 patients, adenocarcinoma in 6, undifferentiated carcinoma in 1, hamartoma in 2 and sclerosing hemangioma in 1. Cardiac procedure included coronary artery bypass grafting (off-pump) in 12 cases, mitral valve replacement in 1 and valve repair in 1. Results No patient died or needed to do re-exploration for bleeding. One patient developed atrial fibrillation postoperatively and recovered soon. One patient developed pneumonia and ARDS who bad to receive tracheostomy but finally he discharged from hospital one month later after the operation. Conclusion Combined lung tumor resection and cardiac surgery are relatively safe in selected patients, especially concomitantly with off pump coronary artery bypass grafting. Lung resection and system medinstinal lymph node dissection for lung canner through second incision had low and acceptable operative morbidity.

Objective:To study the clinical effects of modified surgical method with H-uvulopalatopharyngoplasty(H-UPPP)and traditional surgical method in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)in children.Methods:The clini-cal data of 364 pediatric patients with OSAHS were retrospectively analyzed.The patients were divided into 2 groups and treated by low-temperature plasma knife radio frequency ablation for bilateral tonsil removal combined with H-UPPP(group A,n=204)and low-temperature plasma knife radio frequency ablation only(group B,n=160)respectively.The operative time,intraoperative bleed-ing,postoperative secondary bleeding,VAS of pain following operation,postoperative traumatic white film shedding time,OAH1,LSaO2,ESS scores and complications of the 2 groups were compared.Results:In group A the operative time,intraoperative bleed-ing,VAS,OAHI and ESS scores were lower than those in group B(P＜0.05),wile postoperative traumatic white film detachment time and LSaO2 were higher(P＜0.05).No statistically significant difference in terms of the number of cases of postoperative seconda-ry bleeding and complications was observed between the 2 groups(P＞0.05).Conclusion:The combination of low-temperature plas-ma radio frequency ablation and H-UPPP for the treatment of OSAHS may provide clear intraoperative view,and may improve the treatment effects.