Objective To summarize the experience of long-term survival of the patients under- going orthotopic heart transplantation.Methods Heart transplantation was performed on 2 cases of dilated cardiomyopathy and one case of Keshan disease.Before operation,pulmonary artery pressure was 42-53 mm Hg(5.60-7.07 kPa)and pulmonary vascular resistance 5.6-7.0 wood.The body weight difference between donors and receptors was 10%-15%.There were three same antigens in HLA zygosity experiment for all of three patients.Two cases were subjected to standard heart trans- plantation and one case to whole heart transplantation.All the atriums and big vessels were sutured by evting suture method.Cyclosporin A,azathioprine and corticosteroid were used to prevent patients from rejection.Results Survival time of 3 patients was 13 years and 10 months,12 years and 10 years and 3 months.Heart functions of three patients were NYHAⅠand all of 3 patients are living and working commonly.Six,3 and 1 rejection(s)occurred in 3 patients respectively and cured by appro- priate treatment.Electrocardiogram revealed that case 1 and case 2 had two P waves and case 3 sinus rhythm.Ultrasonic cardiogram showed that in case 1 and case 2,the left and right atriums were enlarged and tricuspid valve had slight backstreaming,and in case 3,all of the cardiac chambers were normal and had no backstreaming of tricuspid valve and mitral valve.No abnormal findings were found in 3 cases by 4-9 times of coronary arteriongraphy.Conclusion The important factors for the patients' long-term survival after heart transplantation include the choice of appropriate donors and acceptors, protection of donors' hearts,selection of appropriate operations and suture methods,rational use of im- munosuppressants and prevention of cardiac allograft vasculopathy.

Objective To evaluate the relationship between combined muhigene detection and response to chemotherapy and prognosis in epithelial ovarian carcinomas(EOCS).Methods A total of 80 ovarian tissue samples taken from the surgical specimens of patients with EOCS of our hospital in the last two decades who had received chemotherapy "after surgery were paraffin-embedded.The samples were divided into 2 groups,good prognosis group(patients who survived more than 2 years,n=46)and poor prognosis group(patients who survived less than 2 years,n=34).The expression levels of ToPo-Ⅱ,Ki-67,MGMT, PCNA,p27,p53,pl6,P-gp,LRP,GST-?,bcl-2,C-myc,Fas,bax,MSH2,MRP and BCRP were investigated by the combination of tissue arrays and immunohistoehemical streptavidin-biotin peroxidase(SP) method in all samples.Data were analysed with SPSS 12.0 for windows.Results There were statistically significant differences in the positive expression levels of P-gp,BCRP,MGMT,MSH2,p27 and p16(62%, 50% and 50% in poor prognosis group vs 33%,28% and 28% respectively,P

OBJECTIVETo investigate the effect of vascular bundle implantation in autogenous bone graft on angiogenesis.

METHODSThirty-six New Zealand white rabbits were evaluated in this study. A portion of bilateral radial bones of a rabbit were removed as free bone grafts, whose periostea were peeled off. In test group, the external maxillary artery bundle was passed through the marrow cavity of the bone. In control group, there was no vascular bundle implantation. Each bone was placed in masseter muscle separately. The rabbits were sacrificed and the specimens were procured at 3 days, 1, 2, 3, 4 and 6 weeks after surgery for histological observation, Chinese ink perfusion and CD34 immunohistochemistry. Microvessel density (MVD) was assessed in order to evaluate angiogenesis of autogenous bone grafts.

RESULTSThe bone grafts were found revascularization in 3 days after surgery in the test group, whereas at 2 weeks in the control group. In 3 days, 1 week, 2 weeks, 3 weeks and 4 weeks after surgery, the MVD of test group was significantly higher than that of control group. In 4 weeks after surgery, angiogenesis of test group reached to peak.

CONCLUSIONVascular bundle implantation improved angiogenesis in non-vascularized autogenous bone graft in this study.

Animals ; Bone Transplantation ; Bone and Bones ; Prostheses and Implants ; Rabbits

OBJECTIVETo evaluate the oncological and functional outcomes in patients undergoing supracricoid partial laryngectomy (SCPL).

METHODSForty-three cases underwent supracricoid partial laryngectomy with functional reconstruction in stage T1b-T4. In these cases, 16 were supraglottic cancers, 21 were glottic cancers, and 2 were subglottic cancers. Three types of supracricoid partial laryngectomy (cricohyoidopexy CHP, cricohyoidoepiglottopexy CHEP and tracheocricohyoidoepiglottopexy TCHEP) were employed accordingly.

RESULTSThe 3- and 5-year accumulative survival rates were 90.7% and 83.7% respectively (Kaplan-Meier method). Median follow-up time was 57 months. Decannulation rate was 95.3% (41/43) in those. The mean time of decannulation was 14 days in patients preserved both cricoarytenoid units and 43 days in those only preserved one cricoarytenoid unit. The removal of epiglottis increased the risk of aspiration and prolonged time of decannulation (P < 0.05).

CONCLUSIONSSupracricoid partial laryngectomy for selected laryngeal cancer is feasible. The patients can gain satisfied survival rate and quality of life.

Aged ; Carcinoma, Squamous Cell ; mortality ; surgery ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; mortality ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Adult ; China ; epidemiology ; Female ; Humans ; Low Back Pain ; epidemiology ; etiology ; Occupational Diseases ; epidemiology ; etiology

AIMTo investigate the water-soluble phenolic glycosides from the whole plant of Bulbophyllum odoratissimum.

METHODSColumn chromatography techniques were used to isolate the chemical constituents, physico-chemical constants and spectroscopic analysis were employed for structural elucidation.

RESULTSBulbophyllinoside (1), a new phenolic glycoside and three known compounds were isolated from the whole plant of Bulbophyllum odoratissimum Lindl. Their structures were determined as 3-hydroxyphenethyl alcohol 4-O-( 6'-O-beta-apiofuranosyl) -beta-D-glucopyranoside (1), 3-methoxyphenethyl alcohol 4-O-beta-D-glucopynanoside (2), 3, 5-dimethoxyphenethyl alcohol 4-O-alpha-D-glucopynanoside (3) and syringin (4).

CONCLUSIONBulbophyllinoside (1) is a new compound.

Glucosides ; chemistry ; isolation & purification ; Glycosides ; chemistry ; isolation & purification ; Molecular Structure ; Orchidaceae ; chemistry ; Phenols ; chemistry ; isolation & purification ; Phenylpropionates ; chemistry ; isolation & purification ; Solubility ; Water ; chemistry

OBJECTIVETo compare the therapeutic effects of the greenlight photoselective vaporization of prostate (PVP) and transurethral electrovaporization resection of prostate (TUVP) for the treatment of symptomatic benign prostatic hyperplasia (BPH).

METHODSOne hundred and sixty-three cases of BPH were treated with PVP and TUVP. All patients were followed up with International Prostatic Symptom Score (IPSS), quality of life (QOL), blood loss, operative time, indwelling catheterization, mean Qmax, residual urinary volume (RUV) and operative complications.

RESULTSIPSS, QOL, Qmax and RUV were significantly improved after either of the procedures (P < 0.05), no significant difference in the improvement of subjective symptoms and objective signs had been noted with the different procedure (P > 0.05). Mean operative time was (37 +/- 15) min for TUVP and (45 +/- 28) min for PVP, the resection time was longer for PVP than TUVP (P > 0.05), but the intraoperative bleeding and catheterization time were less for PVP than TUVP (P < 0.05). Postoperative complications were less for PVP than TUVP (P < 0.05). The incidence of hematuria in TUVP group had been 41.4%, and urinary irritation after PVP group was 55.2% (P < 0.05).

CONCLUSIONSPVP has the same therapeutic effect as TUVP and less adverse side effects than TUVP. It is a new technique for the treatment symptomatic BPH.

Aged ; Aged, 80 and over ; Follow-Up Studies ; Humans ; Laser Therapy ; Male ; Middle Aged ; Prostate ; pathology ; surgery ; Prostatic Hyperplasia ; surgery ; Quality of Life ; Transurethral Resection of Prostate ; methods ; Treatment Outcome

Aged ; Aged, 80 and over ; Humans ; Laser Therapy ; Male ; Middle Aged ; Prostatic Hyperplasia ; surgery ; Treatment Outcome

Chimeric antigen receptor T cell (CAR-T) is a kind of adoptive cell immunotherapy, in which T cells are genetically modified to exert targeted killing effect on tumors. CAR-T cell therapy has shown remarkable antitumor efficacy for the treatment of tumors, especially for hematological malignancies, but is less effective in solid tumors. Single-target CAR-T is prone to off-target effect during application, and there is a risk of relapse or more refractory treatment. The development of double-target or multi-target CAR-T is expected to extend the antigen coverage of target cells, effectively avoids antigen escape and prevents tumor recurrence, and prolongs the survival time of patients. This article reviews the advances of multi-target chimeric antigen receptor T cell, and discusses the prospect of its development.

OBJECTIVETo summarize clinical application of one-stage toenail lengthening in free second toe transfer for reconstruction of the thumb (finger).

METHODSNine patients (male 7, female 2) underwent thumb (finger) reconstruction with second toe transfer were treated by one-stage toenail lengthening technique. Eight were the thumb and 1 was the index finger. Patients aged from 18 to 46 years,with an average of 25 years. A rectangle skin was resected at 0.5 cm away from the eponychium, which was 0.2 cm high and as wide as the toenail. Then stripped U shape flap gently towards proximal end and sutured it. During the operation, the injury of the subcutaneous vascular network should be avoided.

RESULTSSuperficial infection at donor area happened in 1 case and was healed by changing dressings. All the reconstruction thumbs (fingers) had survived completely. 2 to 3 mm extending of toenail length was obtained and the appearance of thumb (finger) was improved. There was no growth deformation of toenail. After 7 to 24 months follow up (the average time 13 months), the appearance of the nail was good.

CONCLUSIONSOne-stage toenail lengthening in free second toe transfer for reconstruction of the thumb (finger), which can obtain a satisfactory appearance of the nail and have no influence on the motion of the reconstruction thumb (finger), is a simple and an effective operative procedure.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Nails ; transplantation ; Reconstructive Surgical Procedures ; methods ; Thumb ; surgery