Objective To establish the model of abdominal heterotopic heart transplantation and grope steady operation methods.Methods The heart transplantation was performed in the control group(group A) and experiment group(group B) with 30 rats in each group.Another 30 animals not performed the operation were as the blank group(group C).During the procurement of the donor heart saline solution containing heparitin was injected into the inferior vena cava of liver.At the same time abdominal aorta was transected.Then heart was perfused until it stopped.The activity of superoxide dismutase(SOD) and content of malondialdehyde(MDA) in blood was measured after transplantation.Results The total perfusion time of the graft was shortened within 2 min and hot ischemia time was shortened within 25 s in the group B.The activity of SOD and content of MDA between two groups was significantly different(P<0.05).Conclusion The perfusing method improved with new technique is quicker and more effective than the traditional one and results in the successful rate improvement.

Objective To improve the diagnosis and treatment of testicular masses associated with congenital adrenal hyperplasia(CAH).Methods A 25-year-old man presented with bilateral testicular nodules.Physical examination revealed palpable multiple nodules in the bilateral testes and epididymides as well as enlarged and hard right testis with uneven surface.Biochemical examination showed testosterone(T) of 18.7 nmol/L,17?-(OH)P＞20.0 ng/ml,positive results of rapid ACTH stimulation test and dexametha- sone suppression test.B-ultrasound demonstrated diffuse testicular lesions with nodules in parts of the bilater- al testes.Bilateral testicular nodules were biopsied,and pathological diagnosis was interstitial cell hyperplasi- a.Positive staining for?-inhibin was observed immunohistochemically.The clinical characteristics of testicular masses associated with CAH were reviewed in combination with the literature.Results Based on medical history,imaging,laboratory and pathologic examinations,the patient was diagnosed with testicular masses as- sociated with CAH.He received oral cortisol at dose of 40 mg daily for 2 weeks,and then at dose of 30 mg daily as maintenance therapy.After treatment of 8 months,B-ultrasound showed complete regression of the testicular tumors.Follow-up of 24 months showed no recurrence of the tumor.Conclusions For patient with bilateral testicular masses,endocrinological evaluation and clinical history taking are indicated to exclude testicular interstitial cell hyperplasia associated with CAH.By oral steroid replacement therapy,hormone-sen- sitive testicular masses can regress.

Objective To investigate the influence of hepatectomy combined with splenectomy on curative effect of primary hepatocellular carcinoma patients associated with hypersplenism.Methods Twenty three cases of primary hepatocellular carcinoma associated with hypersplenism were analyzed retrospectively and divided into hepatectomy combined with splenectomy group (n=10) and hepatectomy combined with ligation of splenic artery (n=13). Peripheral blood samples were collected 1 week before operation and 3 monthes after operation respectively. The levels of CD4, CD8, CD16, CD4/CD8, WBC and PLT in the blood were detected. Survival rate between the two groups was compared. Results There were not significant differences in the expressional levels of CD4, CD8, CD16, CD4/CD8,WBC and PLT before operation, bleeding quantity during the operation and rate of severe complications after operation in the two groups. The expressional levels of CD4, CD16, CD4/CD8, WBC and PLT of hepatectomy combined with splenectomy group were much higher in 3 months after operation than those in 1 week before operation and in hepatectomy combined with ligation of splenic artery group (P

AIM: To investigate whether hypercapnia is protective against acute lung injury (ALI) in a rabbit model, and study it's potential mechanisms. METHODS: Twenty-two healthy New Zealand white rabbits were involved in this study, and randomly allocated to control group (group C), normocapnic group (group N) and hypercapnic group (group H). Oleic acid (0 1 mL/kg) was injected intravenously to establish ALI model. Lung mechanics, hemodynamics, blood-gas analysis, the content of malondialdehyde (MDA) and superoxide dismutase (SOD) activity in lung tissue were measured. Apoptosis was analyzed after 3h mechanical ventilation. RESULTS: (1) Peak airway pressure in group H was significantly lower than that in group N (P

Objective To investigate the protective effects of reducing average radiation dose and increasing protective weight on the auditory system (tympanic cavity,the bony portion of eustachian tube,vestibule,and cochlea) during intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods The planning system (ADAC Pinnacle3 8.0m) with direct machine parameter optimization was used to optimize the IMRT planning for 40 patients with NPC (stage Ⅰ + Ⅱ:20 patients ;stage Ⅲ + Ⅳ:20 patients).Without reducing the radiation dose for target volume,the IMRT planning was optimized by limiting the average dose administered to the auditory system or increasing the protective weight for the protected organs in auditory system.The protective effects were assessed by analyzing the average dose received by the auditory system.Results After limiting the average dose administered to the auditory system without reducing the radiation dose for target volume,the average dose received by the auditory system was significantly reduced (3855.5-5391.3 Gy vs 2960.3-4559.6 Gy,P =0.000 for all) ; when the protective weight for the auditory system was increased,the average dose received by the auditory system was even more reduced (3855.5-5391.3 Gy vs 2725.4-4271.4 Gy,P =0.000 for all).For all three regimens,the average dose was significantly higher in stage Ⅲ + Ⅳ patients than in stage Ⅰ + Ⅱ patients (P =0.000 for all).Conclusions For the IMRT planning for NPC,limiting the average dose administered to the auditory system can greatly reduce the average dose received by the auditory system,and increasing the protective weight for the auditory system can further reduce the average dose received by the auditory system.However,the protective effect on the auditory system may be reduced as the stage of NPC increases.

Objective To investigate the protective effects of hypereapnia on acute lung injury(ALI)in an model of rabbits in vivo,and to observe its effect on oxygen free radicals in the lung tissue in order to uncover the potential mechanisms.Method In the laboratory of pharmacology,China Medical Univereity,twenty-two healthy New Zealand white rabbits were randomly assigned to control group(Group C,n=6)with the injection of normal saline(0.1 ml/kg),and sixteen rabbits were injected with oleic acid(0.1ml/kg)intravenously,and then were randomly dirided into normocapnia group(Group N,n=8)and hypercapnia group(Group H,n=8,FiCO2=8%).Then tracheostomy was performed,and the experimental animals were ventilated for 3 hours after oleic acid or sterile normal saline administration.Lung mechanics,hemodynamics,blood-gas analysis were monitored.The rabbits were exsangninated.and the lungs and heart were taken out from the thorax.The concentration of superoxide dismutase(SOD)and malondialdehyde(MDA)in the lung tissue were assayed.Lung tissue wet/dry ratio and pulmonary permeability index were measured and histologic damage was assessed after three hours'mechanical ventilation.Results Peak airway pressure in Group H was significantly lower than that in Group N and the dynamic lung comphance Was significantly higher than that in Group N(P＜0.05).PaO2 in Group H was significantly higher than that in Group N(P＜0.05).The concentration of MDA in the lung tissue in group H was significantly lower than that in Group N(P＜0.05),and SOD in group H was significantly higher than that in Group N(P＜O.05).Lung tissue wet/dry ratio and pulmonary permeability in group H were significantly lower than that in Group N(P＜0.05).Histological tissus damage in Group N wassignificantly severer than that in Group H.Conclusions Hypercapnia induced by inhalation of high concentration of carbon dioxide(8%)plays protective role in this in vivo model of ALI.The mechanisms may be associated with enhanced SOD activity and the attenuation of lipid peroxidation in the lung tissue.

Objective To analyze the clinical characters in old patients undergoing coronary artery bypass grafting (CABG). Methods The clinical data of 426 patients undergoing CABG from January 2000 to April 2009 in our hospital were retrospectively analyzed. One hundred eighteen patients were 70-82 years old (older group), 308 patients were 24-69 years old (younger group). The perioperative risk factors, surgical complication and outcomes between the two groups were compared.Results The older group had higher incidences of post-operative complications than younger group.Pre-operative risk factors included the female, chronic obstructive pulmonary disease, peripheral vessel disease, New york heart association(NYHA) class Ⅳ, unstable angina requiring intravenous nitrates until arrival in the anaesthetic room, left ventricular ejection fraction ＜30%. The older group showed higher incidences of postoperative severe complication, operative mortality, and more grafts and longer time in intensive care unit (ICU), and had lower incidents of valve disease and less use of left internal mammary artery [16 patients (13. 6%) vs. 152 patients (49.4%), all P＜0. 05].Conclusions The many CABG risk factors in China are different from those in the western countries.Although the higher incidents of postoperative severe complication and higher operative mortality are found in the older patients, the recovery period after operation isn't obviously prolonged. The operative outcomes are satisfactory.

Objective To investigate the effects of metabolic syndrome(MS)on the structure and function of artery in patients with essential hypertension(EH).Methods One hundred forty-eight patients with EH were classified as EH with MS(EH+MS)or EH alone and healthy subjects(n=30)as control.Carotid intima-media thickness(IMT),brachial artery flow-mediated vasodilation(FMD)and non-flow-mediated vasodilation(NMD)were measured by Dopple ultrasonography.Results Carotid IMT(EH+MS:1.0?0.3 vs EH:0.8?0.2 vs control: 0.5?0.1 mm)and hsCRP(EH+MS:0.9?0.4 vs EH:0.7?0.3 vs control:0.4?0.2 mg/L)were significantly higher in EH+MS patients than that in EH+nonMS patients and control subjects(P all

Objective To explore the prophylactic effect of methylprednisolone combined with granisetron on postoperative nausea and vomiting.Methods Two hundred patients scheduled for lumpectomy of breast were randomly divided into four groups with 50 cases each.The patients in group M1 received a pre-anesthesia intravenous doses of methylprednisolone 25 mg,the patients in group M2 were injected methylpredsisolone 25 mg repeatedly four hours later,in group D received a pre-anesthesia doses of dexamethasone 5 mg,in group N normal saline 2 ml.All the four groups of patients received granisetron 3 mg intravenously at the end of surgery.The incidence of nausea and vomiting in the 24 hours were observed.Results The PONV incidences of group M1,M2,D,N were 36%,18%,38% and 58%.Both group M1,M2 and D significantly decreased the total inci-dence of PONV (P <0.05)in the 24 h.The incidence of PONV was significantly lower in group M2, compared with group M1 and group D respectively (P <0.05).Conclusion Methylprednisolone-gran-isetron combination is as equally effective as dexamethasone-granisetron combination for preventing PONV in lumpectomy,but repeated methylprednisolone after 4 h is more effective than dexametha-sone and single-used methylprednisolone.