Objective To explore the clinical diagnosis and surgical treatment of inflammatory pseudotumor of the lung. Methods From January 2002 to December 2008,the clinical data of 50 cases with pulmonary inflammatory pseudotumor were retospectively analyzed. Result 18 cases of preoperative diagnosis, the four cases of lobectomy, pulmonary wedge resection in 13 cases, and the rest are mass surgery, intraoperative tumor mostly see substantive, tumor visceral pleural surface without sag and shrinkage, tumor palpation There are hard and soft white felt, with incomplete tumor capsule, easily stripped. Resection of the pathological specimens were confirmed to be inflammatory pseudotumor, no operative complications and death in patients with follow-up 1～8 years, both curvived, without recurrence. Conclusion Inflammatory pseudotumor of their clinical performance and imaging characteristics of the lack of change in the low rate of preoperative diagnosis, surgical treatment of the main diagnostic, intraoperative frozen biopsy to determine pathology surgery, surgical approach to the limitations of pneumonectomy or lobectomy excision.

Many researches have focused on the wnt-frizzled cascade in the recent years, while much work has been done in neoplastic diseases and embryology, the role of the wnt-frizzled signal transduction pathway in cardiovascular diseases has only recently begun to be explored. It plays a very important role in many physiological and pathophysiological processes, such as its transduction pathway, the healing after myocardial infarction, the proliferation, differentiation and orientation of cardiomyocytes, angiogenesis/neovascularization, cardiac hypertrophy and heart failure, the deposition of the extracellular matrix and so on. This article is aimed at its relation with myocardial infarction and the role of this pathway in cardiovascular diseases.[

Objective To explore the relationship of the (CA)n dinucleotide repeats polymorphism of the eNOS gene with type 2 diabete mellitus (DM) and the serum NO level in DM patients. Methods The eNOS genotype was assessed in 179 unrelated Chinese of Han nationality,including 93 patients with DM and 86 normal controls(NC).Genotype was determined by polymerase chain reaction(PCR) and denature polyacrylamide gel electrophoresis (PAGE) with silver stain.Fasting serum NO level was measured by nitrate reductase and fasting serum NOS level was measured by spectrophotometer. Results Twenty two different alleles were identified containing 19-40 CA repeats,in which the frequency of (CA) 30 (166bp)was the highest. The heterozygosity (H) and polymorphism information content (PIC) were 0.85 and 0.83 respectively. Frequency of allele (CA) 34 was higher in DM (7.5%) than in NC (2.9%) significantly. Compared with NC,the serum NO level was significantly lower in T2DM with genotype (CA)n 1 (CA)n 2 when n 1≥34 or n 2≥34. Conclusions The allele(CA) 34 is associated with the susceptibility to DM and may be involved in the development of DM. The eNOS gene polymorphism is connected with the serum NO level.

Objective To evaluate safety and validity of 3D video-assisted thoracoscopic technology in cardiac surgery.Methods Between October 2013 and July 2014,50 patients underwent 3 D Video-assisted thoracoscopic cardiac surgery including:5 atrial septal defect closure,1 ventricular septal defect closure,repairment of 1 unroofed coronary sinus,1 partial atrioventricular septal defect and 1 cor triatriatum,28 mitral valve replacement (1 re-MVR),1 tricuspid valve replacement,9 mitral valvuloplasty,2 left atrial myoxoma resection,and 1 left internal mammary artery harvest + minimally invasive direct coronary artery bypass.All procedures were performed under extracorporeal circulation,using 30° thoracoscope and 3D high resolution monitor.Results There was no perioperative death.One patient was converted to median sternotomy because of pericardial adhesions.Mean operative time was(232.8 ± 54.7) min,mean cardiopulmonary bypass time was(128.0 ±42.5) min,mean aortic cross-clamp time was (74.7 ± 25.1) min.Mean ICU stay was (30.4 ± 22.0) h,mean duration of mechanical ventilation was(13.7 ± 11.9) h.Mean postoperative drainage time was (3.34 ± 1.91) d,mean hospital stay was (6.52 ± 3.06) days.There were 11 (22％) operative complications,including 4 intrathoracic bleeding,1 wound infection,3 hemothorax,1 brachial plexus injury,1 intractable hiccup and 1 mild paravalvular leakage.Compared with 20 mitral valve replacement by 2D thoracoscopy,the 3 D group was slightly less time consuming(P ＞ 0.05).Conclusion 3 D video-assisted thoracoscopic cardiac surgery is feasible and safe,and it' s worthwhile to promote this promising technology.

Objective To weight the proper treatment for ischemic mitral regurgitation (IMR) patients who require coronary artery bypass grafting (CABG). Patients and Methods 37 CABG patients with IMR during January 2001 and October 2003 were analyzed retrospectively. Results 24 patients underwent CABG alone, there were no operation mortality. The left ventricular diastolic diameter decreased from 52 95 mm to 48 18 mm (P=0 001), LVEF increased from 0 46 to 0 55 (P

Objective To examine whether the minimally invasive video-assisted thoracoscopic surgery(VATS) in atrial septal defect(ASD) closure yields better clinical outcome equivalent to those of more established procedures,such as median sternotomy,moreover,to provide our own clinical experience in ASD Closure.Methods From January 2012 to January 2013,100 ASD patients were treated,50 patients received traditional open heart surgery (OHS group),17 males and 33 females,aged(23.3 ± 7.5) years,weighted (47.5 ± 16.5) kg; 50 patients underwent video-assisted thoracoscopic surgery (VATS group),20 males and 30 females,(22.6 ± 8.2) years old and (49.6 ± 17.2) kg weight.Collected and analyzed the clinical date of intraoperation and postoperation.Results All patients survived after surgery without serious complications like death.Clinical date of both group(OHS group vs.VATS group)include:Total operating room time (121.3 ± 20.5) min vs.(105.3±17.5) min (P＜0.05); tracheal intubation time in ICU (210.0±36.5) min vs.(100.0 ±47.5) min(P＜0.05) ; volume of thoracic drainage after operation (350.3 ± 50.8) ml vs.(47.0 ± 10.9) ml (P ＜ 0.005) ; postoperative length of hospital stay (6.2 ± 1.7) days vs.(4.4 ± 1.5) days (P ＜ 0.005).Rate of return to work in 3 weeks of postoperation 0 vs.78.4％ (P ＜ 0.005).Conclusion Completed VATS in ASD closure is less invasive,accelerates recovery and maintains overall surgical efficacy,which brings good economic and social benefits.For the appropriate patients,and for the experienced and skilled surgeon,completed VATS is the best method of choice of ASD closure in our department.

Objective Background and objective The Cox maze Ⅲ procedure has been considered the gold standard for the surgical treatment of atrial fibrillation (AF) and the modified Cox maze use bipolar radiofrequency ablation instead of the cut-and-sew technique,while also reducing the connecting lines in left atrium.This study was to understand whether completely isolation the posterior left atrium by increasing left atrium ablation lines can enhance the survival after modified Cox maze procedure.Methods From Jan 2009 to Dec 2009,all the patients underwent the Cox maze procedure,following the same examination,were divided into two groups (case-control): box lesion group (n =60),which is means the right and lefi pulmonary vein lesions were connected inferiorly by adding ablation lines,thereby completely isolating the posterior left atrium and the non-box lesion group (n =60).Similar interventions were given during the perioperative periods.Comparing the risk factors before surgeries,then follow-up was 100％ complete,and the mean follow-up was 9 ± 8.4 months.Results Except the box lesion had long time of extracorporeal circulation,the characteristics of the 2 groups were similar because there were no differences in age,AF duration,left atrial diameter,left ventricular ejection fraction or homochronous operation between the groups and there was no operative death.No patient was lost to follow-up.In the mean follow-up duration,a patient was died of intracerebral hemorrhage at 2 months postoperationly in the box lesion group and a patient suffered from stroke at 12 months postoperationly in the non-box lesion.The overall freedom from AF recurrence was higher in the box lesion group at 1 (70％ vs 51.2％,P =0.039) and 3 (78.3％ vs 60％,P =0.030) months.While it was 80％ vs 71.7％ (P =0.286) at 6 months.Eight patients wrere readmitted because of the recurrence of AF,4 and 2 patients underwent catheter ablation in box and non-box group respectively,one patient in each group underwent electrical conversion.After treatment,all of the patients were recovered to sinus rhythm and continued to take cordarone.Conclusion Compared to the single connecting between right and left pulmonary vein,isolating the entire posterior left atrium by creating a box lesion showed higher freedom from AF in the earlier months (1-3months).However,half a year after the surgery,there were no significant differences between the two groups.

Objective Heart transplantation is an effective treatment of end-stage heart diseases and extending the time of donor heart preservation helps to make up for the shortage of donor hearts. This study was to investigate whether high-pressured mixed gas ( HPMG) of carbon monoxide and oxygen could prolong the time of donor heart preservation and its mechanisms. Methods Forty-eight C57BL/6 male mice aged 4-6 weeks were randomly divided in-to four groups of equal number:control ( the donor heart isolated but not transplanted) , immediate transplantation ( the donor heart transplanted right after isolated) , HTK-preservation ( the donor heart preserved in histidine-tryptophan-ketoglutarate solution for 24 hours after isolated, and HPMG preservation ( the donor heart preserved in an HPMG chamber with the oxygen partial pressure of 3200 hPa and carbon monoxide partial pressure of 800 hPa for 24 hours after isolated) .Another 36 recipient mice aged 6-8 weeks were randomly assigned to receive the donor heart immediately after harvested (n=12), preserved in HTK solution (n=12), or preserved in HPMG (n=12).At 2 hours after transplantation, the status of heart re-beating and cardiac function were compared among different groups of recipient mice.At 24 hours, tissues were taken from the transplanted hearts for examination of pathologic changes by HE stai-ning, detection of the apoptosis of cardiac cells by TUNEL, and determination of the expressions of microtubule-associated protein 1 light chain 3 -Ⅱ(LC3-Ⅱ) and B cell lymphoma/leukemia-2 (Bcl-2) by Western blot. Resul ts The re-beating rates of the imme-diately transplanted and HPMG-preserved hearts were significantly higher than that of the HTK-preserved ones (P<0.05).At 2 hours after transplantation, the cardiac function scores were 2.5 (2.0-2.9), 0.8 (0.5-1.0), and 4.5 (4.0-4.5) in the immediate implantation, HPMG-preservation and HTK-preservation groups respectively, with statistically significant differences between any two groups (P<0.05).The expressions of LC3-Ⅱand Bcl-2 were 2.06 ±0.29 and 0.87 ±0.18 in the HPMG-preserved heart recipients and 1.24 ±0.20 and 2.07 ±0.32 in the immediately transplanted heart recipients, both higher than 0.13 ±0.03 and 0.19 ±0.02 in the controls and 0.16 ±0.06 and 0.26 ±0.08 in the HTK-preserved heart recipients (P<0.05), the Bcl-2 higher in the HTK-pre-served heart recipients than in the controls (P<0.05), and the LC3-Ⅱ expression higher in the HPMG-preserved heart recipients than in the immediately transplanted heart recipients (P<0.05).HE staining showed that cell edema and inflammatory cell infiltration were more obvious in the HPMG-preserved heart recipients than in the controls and immediately transplanted heart recipients but less obvious than in the HTK-preserved heart recipients.The rate of cell apoptosis was dramatically increased in the HPMG-and HTK-pre-served heart recipients ([5.04 ±1.77]%and [26.72 ±5.23]%) in comparison with the controls ([1.08 ±0.56]%) (P<0.01) and immediately transplanted heart recipients ([2.13 ±1.71]%) (P<0.01) but decreased in the HPMG as compared with the HTK-preserved heart recipients (P<0.01). Conclusion High-pressured mixed gas preservation can reduce cold ischemia-reperfu-sion injury of the donor heart, which may be associated with its promotion of autophagy, provision of energy to cells, and apoptosis of cardiocytes in the donor heart.

ObjectiveTo investigate the mechanism and the protective effect of heat shock protein 27 (HSP27) on rat cardiomyocytes when ischemic preconditioning performed.MethodsCultured rat cardiomyocytes were divided into four groups: control group, ischemic group,ischemic preconditioning group and cyclohexamide group. Cell viabilities were analyzed by MTT. The apoptosis was evaluated with DNA ladder and flow cytometry Annexin V Flous staining. Western Blot was used to determine the expression of HSP27 and caspase-3 in cardiomyocytes.ResultsIschemic preconditioning could improve cell viability. The apoptosis ratio in ischemic preconditioning group was significantly less than that in ischemic group. These were accompanied by an increase in the expression of HSP27 and a decrease in caspase-3. The expression of the increased HSP27 and the protective effect induced by ischemic preconditioning were completely abolished by the presence of cycloheximide, a translation inhibitor.ConclusionThe expression of HSP27 induced by ischemic preconditioning plays an important role in protecting cardiomyocytes, and the mechanism is possibly related to the inhibition of cell apoptosis.

Although the surgical techniques has already improved in heart transplantation, heart preservation is still the biggest obstacle to the surgery.At present, heart preservation effective time is only 4-6 hour.How to extent the time of heart preservation is a major research direction.Comparison of available preservations for heart transplantation based on its mechanism and the prospect of its Clinical application.