Objective:By monitoring the lung compliance,oxygenation index(OI),CC16、IL-8 in plasma,observe whether the protective lung ventilation in patients undergoing gynecological laparoscopic surgery can improve the respiratoryw function and reduce lung injury.Methods:40 cases of ASA grade Ⅰ-Ⅱ were selected,and 40 patients were treated by elective laparoscopic radical resection of cervical cancer.The patients were divided into two groups according to the random number table method in 40 cases.Mechanical ventilation in general anesthesia,A group used traditional intermittent positive pressure ventilation mode,tidal volume is set to 10ml/KG (PBW);B group used lung protective ventilation strategy,tidal volume is set to 6ml/KG (PBW) + 5cmH2O PEEP + recruitment manoeuvres.For patients before pneumoperitoneum(T0),2 hours after pneumoperitoneum (T1),4 hours after pneumoperitoneum (T2)MAP,HR,CVP,RR and C were observed.In pneumoperitoneum (T0),2 hours after pneumoperitoneum(T1),4 hours after pneumoperitoneum (T2),2 hours after operation(T3),24 hours after surgery(T4) venous,IL-8,CC16 content detection.Results:Before pneumoperitoneum,two groups of patients with pulmonary compliancethe difference was statistically significant(P ＜0.05).Compared T1 、T2 with T0 in A group and B group,the pulmonary compliance all decreased and there existed significant deference(P＜0.05).Notably,A group decreased evidently(P＜0.05).T0,T1,T3,T4 time points in two groups of patients with oxygenation index,the difference was statistically significant (P ＜ 0.05).Two groups of patients with CC16,IL-8content in T1,T2,T3,T4 time point,the difference was statistically significant (P ＜ 0.05).Conclusions:Lung protective ventilation strategy can improve respiratory function in patients with gynecological laparoscopic surgery,and reduce the incidence of lung injury.

Objective To evaluate the clinical features and prognosis of patients with complete left bundle branch block(CLBBB)following transcatheter device closure of ventricular septal defect(VSD)closure. Methods Clinical feathers of 11 patients with postoperative CLBBB in Department of Pediatric Cardiology,Guangdong General Hospital from January 2011 to December 2013 were collected and reviewed retrospectively. They were treated with dif-ferent protocol based on the appeared time of CLBBB occurrence and clinical symptoms. The patients were followed up, and the prognosis was recorded. Results The median age of 11 patients was 3. 9 years(3. 4 to 17. 5 years old). The median interval of intervention therapy to first attack of CLBBB was 2. 8 months(1 day to 25. 4 months). CLBBB oc-curred within 1 week to 1 month postoperatively in 4 patients,another 1 case suffered from CLBBB between 1 week to 1 month postoperatively,meanwhile 6 cases underwent CLBBB after 6 months postoperatively. The longest term of CLBBB attack postoperatively was 25. 4 months in 1 patient. The electrocardiograms on 5 patients returned to normal by only drug treatment. However,3 patients failed to recover with drug therapy,2 of them undertaken surgical procedure to re-move the occluder associated with VSD repair,1 patient recovered to normal and another converted to incomplete right bundle branch block. One of them refused to undertake surgical procedure and still bothered with persistent CLBBB. Another 3 cases did not receive special treatment due to the later attack of CLBBB(≥6 months)without clinical symp-toms. By the end of observation,the electrocardiogram(ECG)in 4 patients returned to normal,4 patients presented with persistent CLBBB. One patient's ECGs were presented with right bundle branch block. After ECG successfully returning to normal ECG by drug therapy,2 patients relapsed during follow - up,and 1 of them developed to an enlarging left ven-tricle and heart failure which led to death. Conclusions CLBBB may occur in short or long - term after VSD closure. ECG may become normal after early and appropriate treatment postoperatively. Systolic dyssynchrony and cardiac dys-function may be caused by persistent CLBBB. Therefore,patients with CLBBB after VSD closure should be treated ap-propriately without delay,and more frequent and longer follow - ups are required.

Objective: To observe the effect of extracorporeal shock wave therapy (ESWT) on proliferation, cell cycle and intercellular adhesion molecule-1 (ICAM-1) expression in human umbilical vein endothelial cells (HUVECs). Methods: HUVECs were culturedin vitro at the concentration of (1×105/ml) and the cells were divided into 2 sets of groups:CSWT group, the cells were treated by different energy of (0.03, 0.09, 0.18, 0.24) mJ/mm2 respectively and corresponding Control group, in which the cells had no CSWT. HUVEC proliferation was detected by CCK colorimetric method, cell cycle was measured by lfow cytometry, mRNA and protein expressions of ICAM-1 were examined by RT-PCR and Western blot analysis respectively. Results: Compared with Control group, (0.09 mJ/mm2) CSWT group had promoted HUVECs proliferation,P<0.05 and the other CSWT groups were similar to corresponding Control groups,P>0.05; (0.09 mJ/mm2) CSWT group showed decreased proportion of G0/G1 stage and increased S and G2/M stages, allP<0.05; while (0.03 mJ/mm2) CSWT group only increased the proportion of G2/M stage,P<0.05 and the other CSWT groups were similar to corresponding Control group,P>0.05. Compared with Control group, (0.09 mJ/mm2 ) and (0.03mJ/mm2) CSWT groups showed increased mRNA expression of ICAM-1 (9.27±0.95) vs (1.02±0.27),P<0.001 and (7.08±0.60) vs (1.02±0.27),P<0.01; (0.09 mJ /mm2) CSWT group had elevated protein expression of ICAM-1,P<0.05. Conclusion: ESWT especially at (0.09 mJ/mm2) may accelerate cell cycle transition from G0/G1 stage to S and G2/M stages, promote HUVECs proliferation and increase ICAM-1 expression which may play important roles in ESWT facilitated angiogenesis in vitro.

BACKGROUND:Studies have shown that extracorporeal shock wave therapy is an effective, safe, and non-invasive treatment for ischemic heart disease, which can improve angiogenesis in the ischemic myocardium. OBJECTIVE:To summarize the research advances in promotion of angiogenesis for ischemic myocardium by extracorporeal shock wave therapy. METHODS:A computer-based online search of PubMed database and CNKI database was performed for relevant articles published between 1998 and 2014 with key words of “shock wave, ischemic heart disease, angiogenesis, cytokine, stem cel” in English and Chinese, respectively. Articles related to the promotion of angiogenesis for ischemic cardiovascular disease by extracorporeal shock wave were selected. Repetitive articles were excluded. According to inclusion criteria, 51 literatures were selected in result analysis. RESULTS AND CONCLUSION: Extracorporeal shock wave therapy can improve angiogenesis in the ischemic myocardium by mobilizing proliferation and differentiation of stem cels into vascular endothelial cels, and by enhancing the expression of growth factors such as vascular endothelial growth factor and basic fibroblast growth factor. Moreover, the extracorporeal shock wave therapy can create a local favorable microenvironment for angiogenesis by inhibiting inflammation, oxidative stress and apoptosis and by regulating components of the extracelular matrix. Extracorporeal shock wave therapy plays an important role in the angiogenesis of ischemic myocardium and displays a good clinical prospect in the treatment of ischemic heart disease. However, the specific mechanism requires further studies.

Objective To evaluate the clinical efficacy of 5-aminolevulinic acid-photodynamic therapy (ALA-PDT) combined with imiquimod for basal cell carcinoma( BCC).Methods 38 patients with BCC were randomly divided into two groups.ALA-PDT plus imiquimod were given in the treatment group (19 patients) , and the control group(19 patients) were treated with only ALA-PDT.All patients were followed for one year,and the efficacy and relapse rate were observed.Results The cure rate and the recurrence rate of the treatment group was 94.74% ( 18/19) and 5.26% (1/19) .however,those of the control group was 68.42% (13/19) and 31.58% (6/19).There was a statistical difference in the cure rate and recurrence rate between the two groups(x2 =4.37,P <0.05).Conclusion The efficacy and relapse rate of ALA-PDT combined with imiquimod was much better than those of ALA-PDT only in treatment of BCC.

Objective To investigate the imaging features of hepatic epithelioid hemangioendothelioma (EHE) and to improve the level of awareness of this disease.Methods A retrospective analysis was conducted on the CT and MRI findings and the clinical data of 16 patients with liver EHE.The diagnosis was made on specimens obtained by liver biopsy or with operation.Six patients received only CT,6 only MRI,4 both CT and MRI,and 4 with DWI sequence.Results 6 of 16 patients with hepatic EHE had a solitary tumor while the remaining 10 patients had multiple tumors.CT scanning on 10 patients showed a heterogeneous mass with low density.In 4 patients,there were small calcifications in the lesions.The lesions on MRI showed a heterogeneous mass with low signal in T1WI and high signal in T2WI and DWI.In 8 patients,during enhanced scanning,the intrahepatic vein and its branches terminated at the edge of the tumor to form the lollipop sign. On the arterial phase lesions with a diameter ＞ 3 cm showed a centripetal enhancement pattern,which is similar to that of a haemangioma.Lesions with a diameter ＜ 3 cm showed ring enhancement and continuous annular enhancement in the portal venous phase and in the delayed phase.The best observation period for the number of lesions was in the arterial phase.Conclusion Hepatic EHE had certain distinct characteristics on CT and MRI,e.g.the lollipop sign,lesions with small calcification,lesions with a diameter ＞ 3 cm with a centripetal enhancement pattern,and lesions with a diameter ＜ 3 cm with continuous ring enhancement on CT scanning.These radiological features help in the diagnosis of the disease.

Objective The extracorporeal cardiac shock wave therapy ( CSWT ) can promote angiogenesis in ischemic myo-cardium and improve myocardial perfusion , but its mechanisms remain to be clarified .This study aimed to explore the effects of CSWT on the endothelial progenitor cells (EPCs), vascular endothe-lial growth factor ( VEGF) and Interleukin-8 ( IL-8) as well as its re-lieving effect on angina pectoris in patients with coronary heart dis-ease. Methods After Dobutamine stress echocardiography ( DSE) and 99 mTc-MIBI myocardial perfusion imaging (MPI) at rest and un-der stress, 25 patients with coronary heart disease underwent 9 three-month cycles of CSWT .Before and after the treatment , we obtained the results of 6-min walk test, NYHA cardiac function grades , CCS angina pectoris classes, Seattle Angina Questionnaire (SAQ) scores, doses of nitroglycerin administered , left ventricular diastolic di-ameter ( LVDD) , and left ventricular ejection fraction ( LVEF) .We evaluated myocardial perfusion and myocardial contractile function using MPI and the peak systolic strain rate (PSSR) at rest and under stress, respectively. Results After CSWT, the numbers of EPCs and EPC-CFUs cultured in vitro were significantly increased as compared with the baseline (34.52±6.58 vs 19.56±4.28, P<0.01;12.44±2.66 vs 5.04±1.90, P<0.01), and so was that of the circulating EPCs in the peripheral blood ([904.73±94.77] vs [815.68±101.08] /mL, P<0.05), the levels of VEGF and IL-8 (155.29±23.6 vs 122.26±18.85, P<0.01;149.37±46.51 vs 21.86± 5.96, P<0.01), the distance of 6-min walk (P<0.01), NYHA cardiac function grades (P<0.01), CCS angina pectoris classes (P<0.01), SAQ scores (P<0.01), doses of nitroglycerin administered (P<0.01), and MPI scores at rest and under stress (2.16±0.16 vs 1.04±0.19, P<0.01;1.40±0.16 vs 0.80±0.16, P<0.01), but no statistically significant differences were observed in LVDD and LVEF before and after treatment (P>0.05).The PSSR showed no significant changes at rest (1.21±0.62 vs 1.04±0.43, P>0.05) but remark-ably increased under stress after CSWT (2.02±1.00 vs 1.35±0.66, P<0.01). Conclusion CSWT can up-regulate the expressions of VEGF and IL-8 and improve the function of EPCs in the peripheral blood , and thus plays an important role in relieving the symptoms of angina pectoris , promoting cardiac function and enhancing exercise tolerance in patients with coronary heart disease .

Objective To further prove the multipotentiality of rabbit bone mesenchymal stem cells (MSCs) by inducing it into cardiomyocytes with 5-azacytidine. Methods MSCs from rabbit were abstracted, isolated, cultured. Then MSCs were induced by 5-azacytidine in vitro for 24 hours. After cultured for 4 weeks, MSCs’ differentiation was studied by immunohistochemistry and electron microscopy technique. Results Some of MSCs induced by 5-azacytidine expressed troponinT . Electron microscopy showed myofilaments. Conclusion MSCs which exist in bone marrow are mutipotential stem cells, and they can be induced into cardiomyocytes by 5-azacytidine in vitro.

Objective To investigate the effect of different time of hypoxia reoxygenation (HR) on cell autophagy and cell viability.Methods According to the different reoxygenation time,H9C2 cells were divided into five groups:normal control group (group A),hypoxia group (group B),reoxygen 2h group (group C),reoxygen 12h group (group D) and reoxygen 24h group (group E).The expression of LC3 Ⅱ/LC3 Ⅰ in each groups was detected by Western Blot,and the activity of myocardial cells was detected by MlT.Results MlT results showed that the viability of the myocardial cells after hypoxia 2h/reoxygenation 2h was significantly lower than that in the normal control group (P＜0.05).The ratio ofLC3 Ⅱ/LC3 Ⅰ of the cells in group B (hypoxia group),group C (reoxygen 2h group),group D (reoxygen 12h group),group E (reoxygen 24h group) was significantly higher than that of group A (normal control group) (P＜0.05).Among them,the ratio of LC3 Ⅱ/LC3 Ⅰ of the cells in group C and D were significantly higher than that of group B (P＜0.05),paticlularly the group D was the highest (P＜0.05).The activity of myocardial cells in group D was the lowest among all groups.Conclusion Culturing in the three gas incubator can obviously decrease the viability of H9C2cells.Hypoxia can activate autophagy,and autophagy increases significantly after reoxygenation.Autophagy may be activated most obviously at 12 hours and decrease to the level of hypoxia group at 24 hours.Cells can be damaged by hypoxia,and further increase of cellular damage may occur after oxygen inhalation.At 12 hours,the cell viability is the lowest,and the cell viability may be improved at 24h.

Objective: To evaluate effects of color matching of different cavosurface margins on the resin composites in vitro.Methods:Twenty extracted human premolars with an A 2 shade buccal surface were used in this study .Rectangular shaped cavities (3.0 mm depth, 2.0 mm width, 2.0 mm length) were prepared in the center of the buccal surfaces .The gingival and occlusal cavosurface margins were prepared to be either shoulder or bevel;the other cavosurface margins remained vertical .Ten teeth were filled with Clearfil AP-X (AP), the other ten with Clearfil Majesty (MJ) and light cured.The color difference at the cavosurface margin area was measured using a spectrophotometer ( CrystalEye ) and evaluated by 3 observers subjectively .The data were statistically analyzed using repeated measures ANOVA and Chi-square test .Results:When measured by CrystalEye , the color difference between the tooth and resin composite was reduced from the center of restoration to the cavosurface margin area .Both objective and subjective evaluations showed that for AP , the color difference at the cavosurface margin area had no statistical difference among 3 types of the margins; for MJ, the color difference at bevel margin area was significantly smaller than that at the vertical margin area .Conclusion: The resin com-posite restorations produced the color matching at marginal area .The color matching of resin composites with higher diffused light transmission property is more susceptible to the type of cavosurface margins . Preparing bevels may reduce the color difference between the restoration and tooth surface .