Objective To explore the feasibility of the small figure-L unilateral transternal incision for the treatment of anterior mediastinal tumor and cyst.Methods Eighteen patients with anterior mediastinal tumor or cyst were enrolled in the study.Under general anesthenia,after a 8to 10 cm middle skin incision was made,a unilateral figure-L partial sternotomy on the side occupied by the tumors was made in the third or forth intercostals space,taking into account the tumors size and location.Tumors were resected with excellent exposure.Results All but one tumors were completely resected during the operation.In 3 cases,tumors encroached on the adjacent lung tissue,and lung tissue was partially resected.In 2cases,tumors invaded the pericardium,and the pericardium was partially removed.Mean operating time was 120 minutes(80~140 minutes).The mean time of hospital stay was 10 days after the operation,and there was no complications.All patients were alive with a mean follow-up period of 24months(8~36 months).Conclusions The figure-L unilateral sternotomy is an effective and useful minimally invisive approach for anterior mediastinal tumors.

BACKGROUND:Researches on establishing restenosis models in rats emphasize the importancc of 2.0 Forgarty balloon catheter import,but little has been mentioned about domestic-made balloon catheter.OBJECTIVE:To explore the characteristics of vessel restenosis model by denuding arterial endothelium with domestic-made 2.0 Forgarty balloon catheter in rats.DESIGN:A randomized controlled animal experiment.SETTING:Laboratory of Pathophysiology,Hunan University of Traditional Chinese Medicine.MATERIALs:This study was performed at the Laboratory of Pathophysiology,Hunan University of Traditional Chinese Medicine between September 2006 and January 2007.Healthy male SD rats,weighing 300-350 g,were selected.The protocol was performed in accordance with ethical guidelines for the use and care of animals.Domestic-made 2.0 Forgarty balloon catheters were made of balloons and catheters.Proliferating cell nuclear antigen(PCNA),collagen I,and SM α-actin immunohistochemical staining kits were provided by Wuhan Boster Bioengineering Co.,Ltd,China.METHODS:The rats were randomly divided into 4 groups:sham-operated group(n=5),7th day model group(n=4),14th day model group(n=5),and 21st day model group(n=4).The vessel restenosis models were established in the latter 3 groups by denuding arterial endothelium with domestic-made balloon catheter in rats.In the sham-operated group,rats were without insertion of balloon catheter.Injured thoracic aortas were taken out for HE staining to observe histological changes of vascular intima.At the meantime,expressions of SM α-actin,PCNA and collagen I were determined by immunohistochemical method in each group.MAIN OUTCOME MEASURES:Histological changes of intima at the thoracic aorta as well as expressions of SM α-actin,PCNA and collagen I.RESULTS:Eighteen rats were included in the final analysis.The aortal vascular walls remained integrity without narrowness of the lumen areas and proliferation of the endothelium,vascular smooth muscle cells(VSMCs)ranged regularly in the mesolamella in the sham-operated group.The endothelium had little proliferation in the 7th day model group.The intima thickened and the area of lumen became narrow in the 14th day model group.The intimal hyperplasia was diffusive and progressive which mainly included VSMCs,the area of lumen narrowed markedly and cells ranged disorderly in mesolamella in the 21st day model group.In the 14th day model group,PCNA level was higher compared to the remaining 3 groups(P＜0.01).SM α-actin level were significantly higher in the 14th and 21st day model groups than in the sham-operated group and 7th day model group(both P＜0.01).There were no significant differences in collagen I among the groups(P＞0.05).CONCLUSION:Vascular intima hyperplasia appeared markedly 14-21 days after domestic-made balloon catheter-induced rat aorta injury.The results suggested that intima hyperplasia is mainly induced by proliferation of VSMCs.

0.05). VAS and ODI were significantly improved in the 2 groups compared with those before operation (P

Objective To investigate the effects of pyrrolidine dithiocarbamate(PDTC) on aquaporin-9(AQP9) expression and brain edema around the hematoma in experimental intracerebral hemorrhage(ICH).Methods 128 SD rats were randomly divided into four groups: normal group,control group,ICH group and PDTC group.According to Rosenberg's methods,the models of experimental ICH were established.The rats in PDTC group were received PDTC intraperitoneally 2 h later.The brain weight column(BWC) at different time point was calculated by gray-wet method,and the expression of AQP9 was examined by immunohistochemistry.Results The BWC and expression of AQP9 in hematoma side of ICH begin to increase 4 h after ICH,peaked at 72 h,and decreased 120 h later.The BWC in opposite side of hematoma also increased 4 h after ICH and peaked at 72 h.Compared with control group,the BWC and expression of AQP9 in ICH group were higher,especially in hematoma side of brain(all(P

Objective To investigate the therapeutic efficacy of surgical treatment of myocardial bridge. Methods Fifteen patients with myocardial bridge had been treated in our hospital from January 1999 to October 2006. Thirteen patients who had typical angina had been treated regularly by medication, but their symptom remission was not satisfactory. One patient suffered from acute myocardial infarction, and another 1 patient complained of palpitation and syncope. All the patients were given surgical treatment. Surgical strategies included minimally invasive off-pump surgery in 9 patients (supraarterial myotomy in 3 patients, coronary artery bypass grafting in 2, and coronary artery bypass grafting with supraarterial myotomy in 4) and on-pump surgery in 6 patients (coronary artery bypass grafting with supraarterial myotomy in 5 patients and supraarterial myotomy in 1). Results All the operations were successfully completed. The operative duration of off-pump and on-pump surgery was 2.8?1.9 h and 3.5?1.7 h, respectively. The extracorporeal circulation time was 59?37 min. No surgery related death or complications occurred. At 3 months after operation, all the patients were free from symptoms, and electrocardiogram returned to normal in 11 patients. During a follow-up for 0.5~7 years (1.9?1.2 years), recurrent palpitation was seen in 1 patient and others reported no angina. Conclusions Surgical treatment of myocardial bridge has good immediate and long-term results.

Objective To introduce the strategy of perioperative blood glucose control and the early outcome in diabetic and non-diabetic patients undergone coronary artery bypass grafting (CABG). Methods A total of 1019 CABG were performed and the patients were divided into diabetic and non-diabetic groups (n=211, 808, respectively). The demography was comparable between the two groups with the exception that the percentage of preoperative myocardial infarction was significantly higher in diabetic group than that in non-diabetic group. Off-pump and conventional CABG were routinely performed and the left internal mammary artery (IMA) and great saphenous vein (GSV) were used as conduit. Perioperative blood glucose was controlled according to the close supervision. The aim of preoperative 6mmol/L and postoperative 8mmol/L was achieved by means of oral medication or subcutaneous injection of insulin, which was complimented by continuous pump infusion of regular insulin to optimize the glucose level. Results 99.2% patients were discharged. The overall perioperative mortality was 0.8% and the percentage was 1.4% and 0.6% respectively in diabetic and non-diabetic group with significant difference(P0.05), respectively. Cerebral infarction occurred in 1.4% diabetic patients and in 0.5% non-diabetic patients(P

Objective To investigate the effect and safety of Compound codeine phosphate syrup with Ambroxol treatment in the stable phase of chronic obstructive pulmonary disease. Methods 100 patients with stable COPD were divided into Compound codeine phosphate syrup with Ambroxolt treatment group (Group A) 50 cases and Compound codeine phosphate syrup treatment group( Group B) 50 cases,drug were given for 3 ～ 7d. The symptom score and efficacy of two groups before treatment and after treatment were compared. Results The symptom score of cough,sputum volume,sputum viscosity ,wheeze,sleep after treatment 8th day were improved significantly ( χ2 = 3. 891 ,χ2 =3. 992, χ2 = 4. 198, χ2 = 3.981, χ2 = 3. 879, allP < 0. 05; Total effective rate of cough, sputum volume, sputum viscosity,wheeze in group A(92. 0% ,94. 0% ,90. 0% ,90. 0% ) higher than that in group B(80.0% ,86.0% ,80. 0%,78.0% ) ( χ2 = 3.991, χ2 = 4. 012, χ2 = 3. 998, χ2 = 3.971, allP < 0. 05); The adverse reactions of A、 B group were 12.0% and 14.0%(χ2 =1.971,P>0.05). Conclusion Compound codeine phosphate syrup with Ambroxol is an effective and safe antitussive in the stable phase of chronic obstructive pulmonary disease.

Objective To study the characteristics of complement expression and the effects of atorvastatin on the complement in rats after the cerebral ischemic infarction.Method One hundred and sixty adult healthy Sprague-Daweley rats were randomly divided into normal group,sham-operated group,ischemia group and treat group.The ischemia group and treatment group were sub-devided into 6 h,12 h,24 h,48 h,3 d,5 d,2week,respectively.The middle cerebral artery occlusion(MACO)model was induced by using filament method,and the thread Was withdraw from the middle cerebral artery after occlusion 2 h.Rats in the sham-operated groupdid not have thread inserted.After wakefulness,the animals The successful of animal model produced was evidenced by the paralysis of contralateral limbs.The animals model in the treatment group treated with Atorvastatins 10 mg once a day for 2 weeks and,rats in the ischemia group did not receive Atorvastatin.The neurological deficit scoring was measured at different intervals in the ischemia and treat ment groups.The expressions of complement C1q and C3 d protein in the brain of the rats in 4 groups were measured by immunohistochemical methods.Result There were a few complement expression in the brain of normal rats,showing no significant difference observed between sham-operated group and normal group(P＜0.05).The complements(C1 q and C3 d)expressied increasubgkt after cerebral ischemia injury,peaked 24 h after ischemia,and returned to normal levels 5 d after ischemia.The expression of complement C1 q and C3 d in the ischemia group were significanfly higher than those in sham-operated group(P＜0.05),The expression of complement C1 q and C3 d in treat ment group were signnificantly lower than those in the ischemia group(P＜0.05).The neurological deficit score in treatment group were signnificantly lower than that of ischemia group.Conclusions The expressions of complement C1 q and C3 d were increase gradually after cerebral ischemia in the rats,Atorvastatin Can inhibit the complement activation,improve neuro logical function of rats.

Deficiency of Qi (healthy energy) and blood stasis are the basic pathological changes of hepatic fibrosis according to the theories of traditional Chinese medicine. Fuzheng Huayu Capsule, a compound Chinese herbal medicine for hepatic fibrosis, is produced in the light of this pathological mechanism. More than a decade of clinical studies and experimental researches show that this medicine has effects of protecting hepatic cells, relieving liver injury, and controlling the development of hepatic fibrosis. It has definite functional mechanisms on anti-hepatic fibrosis. It is a safe and effective medicine for hepatic fibrosis, and deserves to be well introduced to clinic.

Objective To introduce the strategies of coronary artery bypass grafting (CABG) surgery for elderly patients over 65 years old. Methods Three hundred and ninety four elderly patients were retrospectively studied, 92.4% of whom were complicated with other diseases. Off-pump CABG (OPCAB) was used in 248 cases (62.4%). For the remaining patients with severely compromised cardiac function or small target vessel with diffuse lesion, conventional CABG (CCABG) was selected. Left internal mammary artery (LIMA) was harvested with extrapleural harvesting technique and grafted to left anterior descending artery (LAD) in 96.2% of patients. Saphenous vein or radial artery was utilized for the other coronary arteries. Transit-time flowmeter (TTFM) was utilized to make sure that grafts were patent with satisfactory blood flow. Perioperative blood sugar level was controlled at 6-10mmol/L by insulin. Results Grafts of per patient were 3.14?0.55 for on-pump CABG and 2.40?0.81 for OPCAB. Three patients died resulting in a mortality of 0.76%. The incidence of complication was 2.28%. The rest recovered uneventfully. Intubation time of OPCAB was significantly shorter than that of CCABG. Patients were discharged within 11.84?4.95 days after operation. Conclusion Good short-term result, namely low incidence of mortality and complication, could be obtained in elderly patients over than 65 years old undertaking CABG.