Using isolated rat hearts perfused on a langendorff apparatus,ischemic preconditioning (IP) was investigated with 5 min normothermic (at 37℃) or hypothermic (at 30 ℃) ischemia, followed by 10 min of reperfusion before the arrest period, as an adjunct to St. Thomas crystalloid cardioplegia during 180 min ischemia. After basline functional data were obtained, IP was induced 1 control hearts underwent no IP. Results showed that IP improved functional recovery from ischemia during 45 min reperfusion in normothermic ischemic preconditioning group (NP) comparing with normothermic control (NC),P

Objective To summarize the clinical experience of video-assisted thoracoscopic surgery (VATS) for thoracic diseases. Methods Clinical data of 207 patients receiving VATS form October 1997 to March 2004 were retrospectively analyzed. Among them, there were 155 cases of spontaneous pneumothorax treated by pulmonary bubble ligation or resection, 30 cases of spontaneous or traumatic hemopneumothorax treated by urgent exploration, 14 cases of pulmonary benign diseases undergoing pulmonary wedge resection and biopsy, and 8 cases of mediastinal tumor resection. Results Surgical procedures were completed thoracoscopically in 190 patients and were accomplished under thoracoscope with an additional mini-thoracotomy in 12 patients, while conversions to open surgery were required in 5 patients. The time of surgical procedures was 20~180 min (mean, 56 min). The postoperative hospital stay was 5~52 d (mean, 9 d). Postoperative complications occurred in 17 cases (8.2%, 17/207), including 9 cases of persistent air leakage, 6 cases of re-expansion pulmonary edema, and 2 cases of infection of thoracic cavity. Spontaneous pneumothorax reoccurred in 2 patients 3~4 months postoperatively. Conclusions VATS offers more advantages over traditional thoracotomy for the treatment of spontaneous pneumothorax pulmonary bubble, traumatic hemopneumothorax and selected chest benign diseases. The combination with mini-thoracotomy under certain circumstance may contribute to assuring the safety of this procedure.

Objective To study the potential improvement of donor heart storage by A1 adenosine receptor-induced delayed preconditioning and the mechanism.Methods Male Wistar rats were randomly divided into 8 groups. Group A was pretreated with 2-chloro-N6-cyclopen-tyladenosine (CCPA),and 24 h later,the hearts were stored in St.Thomas solution for 4 h at 4 ℃ and reperfused with K-H buffer for 1 h,while group B was only injected with vehicle of CCPA. Similarly,group C was administered with CCPA,and 24 h later,subjected to 3 h of hypothermial ischemia and 1 h reperfusion,while groups D,E,F received antisense ODN (AS),sense ODN and scrambled ODN to the initiation site of rat Mn-SOD mRNA before preconditioning with CCPA,respectively. In the meantime,groups G and H were only administered with AS or vehicle of CCPA,respectively. Left ventricular function,myocardial CK-mb leakage,tissue levels of adenosine triphosphate and Mn-SOD were measured.Results The recovery percentage of ?dp/dt max of left ventricle in groups A,C,E and F were much higher than in groups B,D,G and H ( P

Objective To discuss the feasibility of open heart operation on beating in the congenital heart diseases.Method This kind of operation was put to use in 181 cases of the congenitalheart diseases in order to observe the effects of myocardial protection, prevention from air embolism,et al.Results Operation field exposure was clear enough to finish the manipulation. All but one case was uneventiful postoperatively,especially without air embolism. Conclusion Open heart operation on beating with slight hypothermia is highly feasible in the common congenital heart diseases.

Objective To study the feasibility of additive improvement of heart protection by preconditioning with MLA and adenosine.Methods Rabbits of group A were injected with MLA, then 24?h later the hearts were isolated, mounted on a Langendorff apparatus, preconditioned with adenosine, perfused with filtered modified Krebs-Henseleit(K-H) buffer through left atria, instrumented left ventricular function monitor system and paced ventricularly at 180 beat/min. Hearts were arrested with 4?℃ modified St.Thomas solution, stored for 4?h at 4?℃ in this solution, and reperfused with K-H buffer. Left ventricular function, myocardial CK-mb leakage and tissue levels of adenosine triphosphate were measured. Groups B and C were only preconditioned with MLA or adenosine, respectively, while group D was only preserved with the modified St.Thomas solution in 4?℃.Results The left ventricular function recovery as percentage (+dp/dt max) in groups A, B, C was 70.97 ? 17.92 , 65.54 ? 22.62 , 64.36 ? 16.10 , respectively. If compared with group D ( 39.07 ? 13.78 ), the differences were significant ( P

8kPa, 113 cases of type ASD and VSD with diameter from 0.5 to 2.0 cm were operated upon with open heart technic from June 1995 to June 1999. There was no mortality, no air embolism, except in 4 cases operation was only completed under moderate hyperthermia and cardiac arrest instead due to poor vision of the operating field. 12 cases were complicated by slight hemoglubinuria after 24h of operation, and 1 case by remnant VSD. 95 cases were followed up, and they were in healthy condition. This operative technic is suitable for the repair of secondary ASD, and small or moderate, membranous or para membranous VSD. Its advantage is less myocardial damage, and shorten the duration of cardiac arrest. Air embolism is likely to take place by using this method, but effective method should be taken to prevent it.

Objective:To investigate the effect of neonatal dog peripheral mononuclear cells on left ventricular function, haemodynamic, and infarcted size when transplanted into infarcted myocardium. Methods: Mononuclear cells from neonatal dogs were isolated and purified. The descending coronary arteries of adult dogs were ligated and the cells were injected into the border zone of the infarcted region. The control group was injected with non serum culture medium. Left ventricular pressure, d p /d t max , and power of LV were measured during and 30 d after operation. Echocardiogram(HP Sonos 5500, 2.5 MHz) were performed promptly and 30 d after operation to determine the changes of left ventricular function. Infarcted size, capillary density and cardiac muscle width were measured 30 d after operation. Results: LV pressure decreased in both groups, there were no marked differences between the 2 groups. LV pressure and d p /d t max of transplant group were greater than those of control group 30 d after operation. The systolic and diastolic functions were preserved after mononuclear cell transplantation. Infarcted sizes were lower and capillary density was greater in transplant group than those of control group. Conclusion: Transplantation of neonatal dog peripheral mononuclear cells into the infarcted regions can increase the capillary density and decrease infarcted size, preserving left ventricular function.

Objective:To evaluate the clinical safety and effectiveness of heavy specific gravity levobupivacaine in spinal block.Method:30 selective general surgical patients of ASAⅠ～Ⅱin obstetrics and gynecology were randomly di- vided into levobupivacaine group(L group)and bupivacaine group(B group).After opening the venous channel and transfusing equilibrium liquid 30 mins,the T 4-5 space was selected as the puncture site for the epidural puncture.The 2 medicaments were injected in the rate of 0.1 ml/s respectively.Then the anesthetizing onset time,maintenance time,time of motion blockade and restoration,effect of anesthesia,variations of blood pressure and heart rate and adverse drug reac- tion were observed.Result:The onset time was 82.61?22.10 s in L group and 59.30?21.50s in B group,respectively. The variations of SBP,DBP and HR in L group were less than those in B group.There was no significant difference in the 2 groups in maintenance time,time of motion blockade and restoration and effect of anesthesia.Conclusion:Compared with bupivacaine,heavy specific gravity levobupivacaine can make the same anesthesia effect with a steadier blood circulation. The specific gravity levobupivacaine is a safe and feasible drug for spinal anesthesia.

ObjectiveTo investigate the influence of carbon dioxide pneumoperitoneum,posture on blood pressure,heart rate (HR),pulse oxygen saturation (SpO2) of laparoscopic cholecystectomy (LC)and gynecologic surgery (LP) patients.MethodsTwelve LC patients (LC group)and 13 LP patients(LP group) with ASA Ⅰ - Ⅱ were selected.Anesthesia and muscle relaxation were maintained by propofol,fentanyl,enflurane,atracurium and the systolic pressure (SBP),diastolic pressure (DBP),HR,SpO2 was recorded in the following times:before anesthesia(T0),immediately after inflation (T1),after position adjustment (after 10 win inflation ) (T2),after 30 min inflation ( T3 ),after deflation (the end of operation)(T4).Results The SBP and DBP at T1,T2,T3 [SBP:(138.75 ± 13.22),(140.42 ± 15.88),(138.67 ±16.35) mm Hg( 1 mm Hg =0.133 kPa) ; DBP:(94.42 ± 5.76),(96.25 ± 8.26),(90.42 ± 7.36) mm Hg] was higher than that at T0[SBP:( 135.50 ± 15.31 ) mm Hg;DBP:(83.58 ± 6.70) mm Hg] in LC group(P＜ 0.01 ).The SBP and DBP at T2,T3 [SBP:(136.76 ± 12.55),(136.85 ± 13.22) mm Hg;DBP:(88.38 ±6.54),(87.23 ± 6.34) mm Hg ] was higher than that at T0 [ SBP:( 132.52 ± 10.11 )mm Hg; DBP:(74.61 ± 5.23 )mm Hg] in LP group (P ＜ 0.05 ).There was no significant difference in HR,SpO2 between T0 and the other points in two groups (P ＞ 0.05).ConclusionThe hemodynamic changes have no significant difference between LC and LP;but compared with preoperative,the hemodynamic changes have significant difference after inflation.

Objective: To study the effect and mechanism of delayed preconditioning induced by adenosine A 1 receptor. Methods: Male Wistar rats in group A, C,D,K were preconditioned with CCPA, normal salt, Pyrrolidin diethyldi thiocarbamate(DDTC), DDTC +CCPA, respectively. The hearts were isolated and perfused with H-K buffer solution on the Langendorff apparatus 24 hours later,the isolate heart was perfused modified St.Thomas solution for 180 minutes at 4℃, and then reperfused with the H-K buffer for 60 minutes at 37℃. Results:The left ventricular function (+dp/dt max ,%) and myocardial ATP level in group A were better than those of C, D, K groups (P