Objective To summarize the experience of radical treatment of tetralogy of fallot in adults.Method Between Nov. 1985 and May 2005,115 patients over 18 years of age with tetralogy of fallot underwent total surgical correction.Longitudinal or oblique right ventriculotomy was used to ensure complete release right ventricular outflow obstruction and complete ventricular septal defect closure.Transannular patches were used in 74 patients,right ventricular outflow tract(RVOT) patches in 37 cases,primary closure of right ventricle in 5 cases,respectively.One patient had separate pulmonary main artery and RVOT enlargement.Results Seven patients had residual septal defect and 3 cases suffered from residual RVOT obstruction.Severe cardiac output syndrome occurred in 10 patients and 6 patients died early postoperatively with the mortality rate of 5.22%.Conclusion By careful surgical management,the treatment of total correction in adult patients may result in good effectiveness.

OBJECTIVETo summarize the clinical characteristics, surgical management and postoperative complications in patients with congenital bicuspid aortic valve (CBAV) over 50 years of age.

METHODSFrom January 2009 to September 2011, 73 CBAV patients aged 51-76 years (mean 61.8∓0.73 years) were treated in our center. Except for 1 patient who underwent Bentall surgery and another having Wheat surgery, all the patients received aortic valve replacement (AVR), including 7 with double (mitral and aortic) valve replacement (DVR), 6 with mitral valvular plasty, 11 with tricuspid valvular plasty, 8 with coronary artery bypass graft implantation, 1 with aortic-left ventricular tunnel repair, 1 with atrial maze ablation, and 1 with left atrial thrombosis removal.

RESULTSTwo patients died after the surgery, with a perioperative mortality rate of 2.7%. The cardiopulmonary bypass time was 78-217 min (mean 131.9 ∓6.0 min) with an aortic blocking time of 56-158 min (mean 88.2 ∓4.8 min) and total postoperative ICU time of 23.0-647.4 h (mean 97.9∓10.5 h). The postoperative complications included low heart output syndrome in 5 cases, bleeding in 4 cases, wound debridement in 4 cases, and hemodialysis due to acute renal failure in 1 case. The left ventricular end diastolic diameter reduced significantly after the surgery (52.6∓1.7 vs 43.2∓1.0, P=0.001). No significant changes were detected in the left ventricular ejection fraction (62.3∓2.5 vs 65.5∓1.3, P=0.257).

CONCLUSIONThorough preoperative examination, preoperative risk factor assessment, timely perioperative interventions, careful evaluation of patients' tolerance of surgery, and prevention of surgical complications are essential to decrease the perioperative mortality in elderly patients with CBAV.

Aged ; Aortic Valve ; abnormalities ; surgery ; Coronary Artery Bypass ; Female ; Heart Valve Diseases ; mortality ; surgery ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Postoperative Complications ; prevention & control ; Retrospective Studies

Objective To evaluate the quality of the portal images acquired by computed radiography(CR)system and conventional screen-film system,respectively.Methods imaging plates (IP)and X-ray films of a home-devised lead phantom with a leakage of 6.45% were acquired,and modulation transfer function(MTF)curves of the both images were measured using edge method.Portal images of 40 nasopharyngeal cancer patients were acquired by IP and screen-film system respectively.Two doctors with similar experience evaluated the damage degree of petrosa] bone,the receiver operating characteristic(ROC)curve of CR images and general images were drawn according to two doctors evaluation results.Results The identification frequency of CR system and screen-film system were 1.159 and 0.806 Lp/mm respectively.For doctor one,the area under ROC curve of CR images and general images were 0.802 and 0.742 respectively.For doctor two,the area under ROC curve of CR images and general images were 0.751 and 0.600 respectively.The MTF curve and ROC curve of CR are both better than those of screen-film system.Conclusion The image quality of CR portal imaging is much better than that of screen-film system.The utility of CR in linear accelerator for portal imaging is promising in clinic.

OBJECTIVETo observe the efficacy of electroacupuncture on sepsis and explore its mechanism.

METHODSFifty cases were randomized into an observation group (26 cases) and a control group (24 cases). The therapeutic programs of anti-infection, anti-shock, respiratory support and nutritional support were provided, but the drugs that might affect gastrointestinal motility were not prescribed in two groups. In the observation group, on the basic treatment as above, electroacupuncture was applied to Zusanli (ST 36), Tianshu (ST 25), Shangjuxu (ST 37), Xiajuxu (ST 39). The excretion ratio of lactulose to mannitol (L/M) in urine and serum D-lactic acid level were detected before and after treatment, as well as the time of target feeding of the patients in two groups. The efficacy was compared between two groups.

RESULTSAfter treatment for 3 days, L/M was (0.083 +/- 0.020) and serum D-lactic acid was (0.155 +/- 0.196) mmol/L in the observation group, which were apparently reduced as compared with (0.123 +/- 0.034) and (0.193 +/- 0.377) mmol/L in the control group respectively (both P < 0.05). The time of target feeding was (93.69 +/- 27.58) h in the observation group, which was shortened apparently than (118.17 +/- 40.28) h in the control group (P < 0.05). The total effective rate was 80.8% (21/26) in the observation group, which was better than 54.2% (13/24) in the control group (P < 0.05).

CONCLUSIONConventional treatment combined with electroacupuncture can improve intestinal permeability in sepsis patients, recover intestinal function as quickly as possible to achieve target feeding.

Acupuncture Points ; Aged ; Aged, 80 and over ; Electroacupuncture ; Female ; Humans ; Intestines ; metabolism ; Lactulose ; metabolism ; Male ; Mannitol ; metabolism ; Middle Aged ; Permeability ; Sepsis ; metabolism ; therapy

Objective To systematically evaluate the clinical efficacy of the prescriptions for softening hardness to dissipate mass combined with Levothyroxine Sodium in the treatment of postoperative thyroid cancer,and to provide evidence-based medical proof for clinical treatment of postoperative thyroid cancer.Methods Computer search was performed in the major domestic and oversea databases for the retrieval of clinical randomized controlled trials(RCTs)of prescriptions for softening hardness to dissipate mass combined with Levothyroxine Sodium for the treatment of postoperative thyroid cancer.After screening the literature according to the inclusion and exclusion criteria,the quality of the included literature was evaluated using the tools for analysis of the bias recommended by Cochrane Reviewer's Handbook and the modified JADAD rating scale,and meta-analysis was performed using RevMan 5.4 software.Results A total of 11 RCTs involving 749 patients were eventually included.The results of meta-analysis showed that compared with Levothyroxine Sodium alone,prescriptions for softening hardness to dissipate mass combined with Levothyroxine Sodium significantly enhanced the efficacy of postoperative patients with thyroid cancer(RR=1.30,95%CI[1.21,1.41],Z = 6.81,P＜0.000 01),and improved the thyroid functions parameters of serum thyroid stimulating hormone(TSH)(SMD=-1.75,95%CI[-2.38,-1.13],Z = 5.47,P＜0.000 01),thyroglobulin(TG)(SMD=-1.13,95%CI[-1.71,-0.55],Z = 3.81,P = 0.000 1),free triiodothyronine(FT3)(SMD=3.42,95%CI[0.73,6.10],Z = 2.50,P = 0.01),free thyroxine(FT4)(SMD=1.85,95%CI[0.05,3.66],Z = 2.02,P = 0.04),and thyroglobulin antibody(TgAb)(SMD=-0.63,95%CI[-1.11,-0.15],Z = 2.55,P = 0.01),increased Karnofsky Performance Status(KPS)scores(SMD= 2.19,95%CI[1.30,3.08],Z = 4.81,P＜0.000 01),shortened the time for the relief of clinical symptoms after thyroid cancer surgery(MD=-4.67,95%CI[-5.38,-3.96],Z = 12.87,P＜0.000 01),reduced the diameter of the largest thyroid nodule after thyroid cancer surgery(MD=-2.51,95%CI[-3.13,-1.89],Z = 7.94,P＜0.000 01),regulated the immune function indicators of T lymphocyte population CD3+(MD=8.68,95%CI[4.97,12.39],Z = 4.59,P＜0.000 01)and CD4+(MD=10.77,95%CI[5.46,16.08],Z = 3.97,P＜0.000 1)levels,and reduced the incidence of postoperative complications of thyroid cancer(RR=0.34,95%CI[0.18,0.65],Z = 3.26,P = 0.001).The differences were all statistically significant(P＜0.05).Conclusion prescriptions for softening hardness to dissipate mass combined with Levothyroxine Sodium can enhance the efficacy of postoperative patients with thyroid cancer.The combined therapy is superior to Levothyroxine Sodium alone in improving thyroid function indicators,KPS score,time for the relief of clinical symptoms,diameter of the largest thyroid nodule,immune function indicators,and the incidence of postoperative complications.However,due to the small amount of included trials and the fact that the prescriptions for softening hardness to dissipate mass vary in the composition,the conclusions of the analysis need to be confirmed by more high-quality,multi-center,large-sample clinically randomized controlled trials.

OBJECTIVETo study the anti-tumor immunotherapeutic effect induced by the suicidalcancer vaccine FC/TK, and to evaluate the safety of this vaccine.

METHODSThe suicidal cancer vaccine, named FC/TK, was prepared by fusion of suicide gene (HSVI,-TK gene) -modified ovarian carcinoma NuTu-19 cells with rat bone marrow-derived dendritic cells (DCs). The morphology of FC/TK was evaluated by scanning electron microscopy. The stimulatory effect of FC/TK on T cells was determined by T cell proliferation assay. In immunotherapeutic studies in vivo, Fischer344 rats were injected subcutaneously with NuTu-19 cells, followed by treatment of FC/TK on days 7 and 14, compared to controls treated with irradiated FC/TK, FC or PBS, respectively. Tumor incidence and volume were measured in 90 days after challenge. To determine the killing effect of FC/TK in vivo, TUNEL assays were applied to detect apoptotic cell death in spleen of vaccinated rats with prodrug ganciclovir administration.

RESULTSFC/TK cells were of irregular shape with surface membrane processes. Compared to the control groups, FC/TK significantly promoted T cell proliferation (P <0.01). The rats vaccinated with FC/TK and FC significantly inhibited the tumor growth compared to rats vaccinated with irradiated FC/TK (P <0.05) or with PBS ( P <0.01). The immunotherapeutic effect induced by FC/TK was similar to that using FC. Fluorescence microscopy showed that fluorescein-stained FC/TK cells migrated into spleen also showed to be TUNEL-positive, suggesting that the FC/TK cells were killed by ganciclovir in vivo.

CONCLUSIONOur data indicate that suicidal cancer vaccine is an effective and safe therapy for ovarian carcinoma and may serve as a broadly applicable approach for other cancer vaccines in the future.

Animals ; Apoptosis ; drug effects ; Cancer Vaccines ; immunology ; Cell Fusion ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dendritic Cells ; cytology ; immunology ; Female ; Ganciclovir ; pharmacology ; Genes, Transgenic, Suicide ; Herpesvirus 1, Human ; enzymology ; genetics ; Immunotherapy ; methods ; Microscopy, Electron, Scanning ; Microscopy, Fluorescence ; Neoplasms, Experimental ; enzymology ; pathology ; therapy ; Ovarian Neoplasms ; enzymology ; pathology ; therapy ; Rats ; Rats, Inbred F344 ; Survival Analysis ; T-Lymphocytes ; drug effects ; metabolism ; pathology ; Thymidine Kinase ; genetics ; metabolism ; Transfection

OBJECTIVETo study the radiobiological characteristic of human nasopharyngeal carcinoma cell lines CNE1 and CNE2 and the changes in expression MRN (Mre11-Rad50-Nbs1) complex in the cell lines exposed to irradiation.

METHODSCNE1 and CNE2 were irradiated by a linear accelerator. Radiobiological characteristics were detected by colony assay and MTT assay. MRN complex expression were examined by Western blot.

RESULTSSurviving fraction at 2 Gy (SF2), quasi-threshold Dose (Dq), and mean lethal dose (Do) of CNE1 were 0.56, 1.449 Gy and 1.480 Gy; SF2, Dq, and Do of CNE2 were 0.44, 0.776 Gy and 1.685 Gy, respectively. Survival fraction of CNE1 at the day 6 after 4 Gy irradiation was 0.59 and that of CNE2 was 0.79 when compared with control, with the up-regulated expressions of Rad50 in CNE1 and Mre11, Rad50 and Nbs1 in CNE2 (P < 0.05).

CONCLUSIONSCNE1 and CNE2 were sensitive to radiation, but there were radioresistance cells in CNE2. The expressions of some components of MRN complex were up-regulated to repair DNA lesions induced by radiation.

Carcinoma ; Cell Cycle Proteins ; metabolism ; Cell Line, Tumor ; radiation effects ; DNA Repair ; DNA Repair Enzymes ; metabolism ; DNA-Binding Proteins ; metabolism ; Gene Expression Regulation, Neoplastic ; Humans ; MRE11 Homologue Protein ; Nasopharyngeal Neoplasms ; pathology ; radiotherapy ; Nuclear Proteins ; metabolism ; Radiation Tolerance

OBJECTIVETo explore whether angiotensin-(1-7) [Ang-(1-7)] protects cardiac myocytes against high glucose (HG)-induced injury by inhibiting ClC-3 chloride channels.

METHODH9c2 cardiac cells were exposed to 35 mmol/L glucose for 24 h to establish a cell injury model. The cells were treated with Ang-(1-7) or the inhibitor of chloride channel (NPPB) in the presence of HG for 24 h to observe the changes in HG-induced cell injury. Cell counter kit 8 (CCK-8) assay was used to test the cell viability, and the morphological changes of the apoptotic cells were detected using Hoechst 33258 staining and fluorescent microscopy. The intracellular level of reactive oxygen species (ROS) was examined by DCFH-DA staining, SOD activity in the culture medium was measured using commercial kits, and the mitochondrial membrane potential (MMP) of the cells was tested with rodamine 123 staining. The expression level of cardiac ClC-3 chloride channels was detected with Western blotting.

RESULTSExposure of H9c2 cardiac cells to 35 mmol/L glucose for 24 h markedly enhanced the expressions of cardiac ClC-3 channel protein (P<0.01). Co-treatment of the cells with 1 µmol/L Ang-(1-7) and HG for 24 h significantly attenuated HG- induced upregulation of ClC-3 channel protein expression (P<0.01). Co-treatment of the cells exposed to HG with 1 µmol/L Ang-(1-7) or 100 µmol/L NPPB for 24 h obviously ameliorated HG-induced injuries as shown by increased cell viability, enhanced SOD activity, decreased number of apoptotic cells, and reduced intracellular ROS generation and loss of MMP (P<0.01).

CONCLUSIONClC-3 channels are involved in HG-induced injury in cardiac cells. Ang-(1-7) protects cardiac cells against HG-induced injury by inhibiting ClC-3 channels.

Using the electron spin resonance (ESR) and probe technique, the species of reactive oxygen free radicals and the oxygen consumption were observed in the metabolic process of oxygen of leukocytes from leukemia patients and healthy persons. Results showed that weak ESR spectrum of hydroxyl radical ((*)OH) signal was detected in the leukemia patient's leukocytes, there was no significant difference in oxygen consumption with or without PMA stimulation; superoxide anion (O(2)) in normal leukocytes was detected, and oxygen consumption increased markedly compared to the normal respiration without PMA stimulation (P < 0.001). There was no significant difference in oxygen consumption between leukemic and normal leukocytes without PMA stimulation; however, it was higher in normal leukocyte than in leukemic leukoeytes after PMA stimulation (P < 0.001). These observations suggest that dysfunction of respiratory burst is existed in leukemic leukocytes, and their oxygen consumption is markedly lower than that of normal leukocytes.