Objective to summarize the clinical experience and results of 50 cases of mitral valve surgery via right anterolateral mini-thoracotomy technique. Methods Patients of mitral valve diseases who accepted such less invasive technique with cap lamp between October 2008 and February 2010 were reviewed.Out of a total 50 cases,38 rheumatic cases underwent mitral valve replacement,12 degenerative cases underwent mitral valvuloplasty,22 cases underwent associated tricuspid valvuloplasty.Preoperative transthoracic echocardiography(TTE) manifest mean left ventricular ejection fraction(LVEF) was 57.3±6.0%.According to NYHA classification,32 patients were in NYHA class II while the other 18 in class III. Diagnosis was identified according to history, physical examination, ECG as well as TTE. There was no statistical difference with regard to age, body weight, cradiothoracic ratio,size of left atrium,size of left ventricle and LVEF comparing with homochronous mitral valve surgeries via median sternotomy.All the patients adopted single lumen trachea cannula and were positioned on his/her back with a 20-30 elevation of the right side, the right arm was suspended over the head. Cardiopulmonary bypass was established between the femoral artery and bicaval venous cannulation. A 6-8cm incision was created in the right submammary fold and the right chest cavity was entered through the fourth intercostalspace.In addition,two other ports were necessary with one positioned at the cross-point of right medioclavicular line and second intercostalspace for placing long myocardial perfusion needles and superior vena cava blocking belt and the other positioned at the cross-point of right midaxillary line and fourth intercostalspace for placing special aortic clamp as well as inferior vena cava blocking belt. Surgeons should wearing headlamps to obtain a clear operation field. The procedures were then performed through an interatrial septum or interatrial groove incision.Result None of the 50 patients turned into median sternotomy during surgeries, there was no case of prolonged intubation, failure of important organs, hemoglobinuria or death,4 cases appeared hypoxemia during surgeries because of high-frequency ventilation with low tidal volume and all Improved after being treated. One case was complicated by active bleeding of intercostal arteries and recovered uneventfully after secondary hemostasis. Comparing with a group made up of 50 patients of the same period who underwent traditional mitral valve surgery through median sternotomy, there was no statistical difference regarding total operation time(130-206,152.0±42.6min:120-190,145.6±50.4min),the mean bypass time(58-147,75.1±20.3min:56-140,72.0±19.3min),the cross-clamp time (29-71,42.9±16.5min: 27-66,41.7±14.7min),mean parallel cycle time(18-60,28.5±12.8min:21-50,29.5±12.0min)(P>0.05). Tracheal intubation time was similar for both groups.(3.5-12,5.2±2.8h:4-14,5.5±2.6h)(P>0.05).The drainage volume of the mini-invasive group was significantly less when comparing with traditional group and all removed their chest tubes on 1st postoperative day.The mean volume were 40-600(105±40)ml and 150-1000 (300±80) ml, respectively(P<0.05). Volume of blood transfusion was also significantly less than traditional group(200±50ml:300±100ml)(P<0.05).TTE before discharged manifest all mitral valve prosthesis had good function, no paravalvular leak was detected, mitral regurgitation and tricuspid regurgitation following valvuloplasty was mild.Conclusion On-pump mini-invasive mitral valve surgery via right submammary thoracotomy which entered the right chest cavity through the fourth intercostalspace together with the using of headlamps can provide a clear operation field. The operating procedure is simple, more important, it is less invasive, less draining and has shorter mean hospital stay and hidden incision. The operation is safety and early postoperative result of this new procedure is satisfactory.

Objective The aim of this study was to assess the value of △Np63α in predicting tumor recurrence after curative resection in esophageal squamous cell carcinoma (ESCC) patients.Methods We analyzed △Np63α protein cxpression in 304 clinicopathologically characterized ESCC cases by immunohistochemistry.Results We found △Np63α expression was positive in 122 (40％) of 304 cases.△Np63α expression was higher in the cancer tissue than in non-tumorous control tissue at protein level(P =0.034).There was a significant difference of △Np63α expression in patients categorized according to invasive depth (P =0.001),tumor position (P =0.001) and lymph nodes metastasis condition (P =0.001).Multivariate analyses showed that △Np63α was an independent prognostic marker for ESCC recurrence.Conclusion △Np63α is associated with outcome of ESCC and can be a novel predictor for poor prognosis of ESCC patients after curative resection.

The relationship between bone mineral density (BMD) and Zn, Cu, Ca levels in the meal and hair of urban and rural elderly people were studied. 470 subjects above 60 years old (urban 205 and rural 265), 178 males with an average age of 65.70 +/- 3.48 and 292 females with an average age of 65.90 +/- 4.02, were inquired. The BMD and Zn, Cu, Ca levels in the meal and hair were measured. The detected BMD in urban and rural female old people was significantly lower than that of the males; The contents of Ca and Zn in the meal of the urban females were significantly lower than those of the urban males; The Ca, Zn in the meal and Zn in the hair of the rural females were significantly lower than those of rural males (P < 0.05 or 0.01). The BMD, Ca intakes, Ca and Zn in the hair of the rural old people were significantly lower than those of the urban old people (P < 0.05 or 0.01). There was a correlation between BMD with the Ca, Zn of the hair and dietary Ca, Zn, Cu or between dietary Zn with Ca, Zn in the hair and Ca, Cu intakes. The Zn, Cu and Ca levels in the meal nutrients were correlated with BMD to some degrees. Lack of Ca and Zn in the meal can cause the reduction of BMD.
Bone Density ; Cadmium/*analysis ; Copper/*analysis ; Diet Surveys ; Hair/*chemistry ; Nutritional Status ; Osteoporosis/prevention & control ; Rural Health ; Zinc/*analysis

Objective:To study the effect of increased expression of Fas on the killing of ? cells Methods:The level of Fas expression and apoptosis of human ? cells strain (NIT) were detected by FACS Results:There is no Fas expression on NIT But Fas expression can detected by culturing NIT with IFN ? and/or TNF ? The apoptosis of NIT induced by sFasL and anti Fas correlates with the level of Fas expression Conclusion:Fas expression induced by cytokine may represent a factor for the initiation of ? cells destruction

Objective:To explore the mechanism of anti CD4 antibodies effect on SEB induced proliferation of the peripheral blood mononuclear cells (PBMC) Methods:Using MTT method to observe anti CD4 antibodies effect on PBMC proliferation in different conditions Using morphologic, biochemistry and flow cytometer methods to detect CD4 +T cells apoptosis induced by anti CD4 antibodies Results:Both anti CD4 human/murine chimeric antibodies and murine McAbs could inhibit the SEB induced PBMC proliferation Anti CD4 chimeric antibodies could specially induced CD4 +T cells apoptosis Conclusion:Most important inhibitory effects of the anti CD4 antibody appear to direct at TCR induced early activation signals, and their inhibitory effect of anti CD4 chimeric antibodies is close related to the monocytes The further cross linking of anti CD4 antibodies is important for inducing CD4 +T cells apoptosis

Objective To analyze the abnormal detectable rates of different kinds of blood test indexes before and after treatment in the patients with snake bite and to probe into the change condition of these indexes after different snake bite .Methods The inpa‐tients with clearly diagnosed what kind of snake bite in the past two years were selected as the research subjects .The multiple blood test indexes were determined before and after treatment in these patients .The abnormal detectable rates of these indexes were ana‐lyzed and compared among various snake bite patients .Results The different kinds of snake bite all could cause the different de‐grees of changes in some detection indexes among partial patients .Specially ,the detectable rates of WBC ,PT ,APTT ,TT ,D‐D ,CK , CK‐MB ,LDH ,Urea ,Cr and Cys‐C increase and PLT and Fbg decrease caused by viper bite were apparently higher than those caused by other kinds of snake bites (P<0 .05) .The detectable rates of CO2 increase and K+ decrease in the coral snake bite were apparently higher than those in trimeresurus gramineus ,cobra and viper bite (P<0 .05) .Conclusion Because the snake species and toxicities are different in the various snake bites ,so the caused changes and the abnormal detectable rates of blood test indexes also are different .

Objectives To construct a small interfering RNA (siRNA) targeting vascular endothelial growth factor (VEGF) in eukaryotic expression vector, and to assess effects of this vector on proliferation and apoptosis of malignant melanoma cell line A375. Methods pU-VEGF-siRNA plasmid was transfected into A375 cells by electroporation. VEGF mRNA and protein were detected by reverse transcription polymerse chain reaction (RT-PCR) and ELISA, respectively, in A375 cells after gene transfer. Proliferation of A375 cells was assessed by cell counting. Human umbilical vein endothelial cells (ECV-304) were cultured in medium containing supernatants of treated and untreated A375 cells, and their viability was tested by cell counting. Apoptosis of A375 cells was observed by flow cytometry (FCM). Results VEGF mRNA and protein were significantly decreased in the experimental group, compared to those in the controls (P

Objective To explore the change regulation of blood coagulation function before and after treatment of snake bite pa‐tients .Methods A total of 226 hospitalized patients with clear diagnosis belong to what kind of snakes in the past two years were selected in this study ,39 cases were bit by coral ,76 cases were bit by trimeresurus stejnegeri ,47 cases were bit by cobra ,24 cases bit by king cobra ,40 cases were bit by adder .Five blood coagulation indexes were determined before and after treatment various pe‐riods for these patients .The tested results were made to statistical analysis according to kind of snakes ,periods and disease condi‐tion .Results D‐D level obvious .rise before treatment for the severe cases patients of coral snake bite (P<0 .05) .Plasma prothrom‐bin time (PT) ,activated partial clotting enzyme live time (APTT) ,thrombin time (TT)and D‐D level rise and Fib level reduced be‐fore treatment for the severe cases patients of trimeresurus stejnegeri bite ,and Fib and D‐D level before and after treatment had sta‐tistical significant difference with the mild patients (P<0 .05) .Every index for the cobra and king cobra had no statistical signifi‐cant differences (P>0 .05) before and after treatment ,only D‐D level of the severe cases had statistical significance before treat‐ment in contrast to the mild cases of cobra bite (P< 0 .05) .The changes of 5 item blood coagulation indexes were all very large whether mild or severe for viper bite patients ,a number of comparisons had statistical significance difference (P<0 .05) whether before or after treatment and whether mild or severe for viper bite patients .Conclusion The bite of coral snake ,cobra and king co‐bra affect little for the blood coagulation function .The severe cases patients of trimeresurus stejnegeri bite might lead to more seri‐ous blood coagulation function abnormality but the recovery is faster after treatment .The viper bite might lead to maximum blood coagulation function abnormality and the recovery is slow after treatment .

Objective To validate the value of Simplified Renal Index Score(SRI) in predicting acute renal injury requiring renal replacement therapy(RRT-AKI) after cardiac valve surgery in Chinese adult patients.Methods An analysis was conducted for all the adult patients who underwent cardiac valve surgery from January 2010 to December 2014 in Changhai Hospital,Shanghai.A total of 3 183 adult patients were included.Based on SRI Score,the patients were divided into 3 risk stages:0 to 1 point,2 to 3 point,and 4 to 8 point.The incidence of RRT-AKI was compared between different stages.And the prediction value of the SRI model was assessed by area under the receiver operating characteristic curve (AU-ROC) and the model calibration was assessed with the Hosmer-Lemeshow (H-L) test.Results After surgery 52 (1.6％) patients developed acute kidney impairment and subsequently underwent renal replacement therapy.Patients with low values of simplified renal index (0-1),medium(2-3) and high values (4 and more) were found to have increasingly higher risk for renal replacement therapy of 0.8％ (95％ CI:0.005-0.012) 、3.8％ (95％ CI:0.026-0.052) 、20％ (95％ CI:0.010-0.720),respectively.TheAU-ROCwas0.68(95％ CI:0.610-0.760,P＜0.01).The H-L test was x2 =2.45,P=0.29.Conclusion SRI model gives a certain clinical significance,suggesting that high-values patients may occur RRT-AKI with a significantly higher risk than low-values patients.However,SRI model cannot give an accurate prediction value for RRT-AKI in Chinese adult patients after cardiac valve surgery.Direct clinical use of the model should be considered cautiously.

The purpose of this study was to construct expression vectors of idiotype (Id) SmIg in patients with B-chronic lymphocytic leukemia and to express them in E.coli to obtain recombinant Id, and to investigate the effect of the protein on the proliferation and secretion of IL-2 and IFN-gamma of stimulated peripheral blood mononuclear cells (PBMC) in vitro. Light chain gene and Fd fragment of heavy chain gene were inserted into fd-tet-DOG2 vector to construct fd-tet-DOG2-Fab. Fab gene was further cloned into expression vector pHEN2 to construct the soluble expression vector pHEN2-Fab. After induction by IPTG, Fab protein was purified by Ni-NTA-chromatography. MTT was used to determine the effects of purified protein on the proliferation of stimulated PBMC in vitro and the concentrations of IL-2 and IFN-gamma in the culture supernatants were detected by ELISA. The results showed that recombinant pHEN2-Fab expression vector was constructed successfully. Fab protein was expressed in positive clone after induced by IPTG and two specific bands at 24-25 kD position were observed by SDS-PAGE electrophoresis. Proliferation of PBMC could be induced by purified Fab and the concentrations of IL-2 and IFN-gamma in culture supernatants were increased significantly after induction. It was suggested that the expression vector of SmIg Fab fragment was constructed successfully, and expressed and secreted from E. coli. The Fab protein could induce proliferation of PBMC and promote secretion of IL-2 and IFN-gamma.