Objective To improve the efficiency of donated organs and to investigate the possi- bility and operation protocol of heart and lung transplantation from the same donor to different reci- pients.Methods The organs of heart and lung were obtained from three donors through the method of orthotopic lavage and whole cutting,and transplanted to end-stage patients with heart diseases or lung diseases.First,the donor was subjected to mechanical ventilation,thoracotomy and lavage of heart and lung.The heart and lung were cut in whole and separated.The recipients were subjected the re- trograde lavage of heart and lung.In the patients receiving unilateral lung transcription,the left and right lungs were isolated.Among 3 recipients of lung transcription,one underwent left unilateral lung transplantation and 2 bilateral lung transplantation.Three cases received orthotopic cardiac transplan- tation by using bicaval orthotopic heart transplantation (BOHT) anastomosis method.Results One recipient of left unilateral lung transplantation recovered well after operation.In one recipient under- going bilateral lung transplantation,right upper lung embolism occurred.After re-operation of cutting the right upper lung on the 9th day of the first one,he recovered from the illness.In another recipient receiving bilateral lung transplantation,anastomotic stenosis of trathea and pulmonary infection occurred after operation.After expectant treatment,he recovered from the illness,but died from serious infection 7 months after operation.One of the heart recipients was found having renal failure of first stage,and recovered from disease after hemodialysis treatment.Quality of life was good in all 3 heart recipients after operation and their heart function achieved the restoration of 0-Ⅰstage.Conclusion The treatment protocol of transplantation from the same donor to different recipients at the same time, which can make full use of the organs from donors,is feasible and has good effect.

The influence of Chang-Bai Xin kui(长白新圭) on the acid ?-naPhthyl acetate esterase(ANAE) positive lymphocytes was studied by using ANAE as a cytochemical marker.S180 cells ef ascites tumor were inoculated into the mice in experimental and control group. 3 days later, 0.8mg/0.2ml of Chang-Bai Xin Kni was injected peritoneally into the mice in experimental group everyday in 7 days. Eaeh of the two groups has its own self control.The experimental results show that there is no significant differences in total numbar of ANAE positive lymphoctes between the two groups and all self-controls.But after 7 days of injecting the drug, the granular pattern and scattered granular pattern of lymphoctes were increased significantly(P

AIM and METHODES: To evaluate the possible signal transduction mechanism of nontargeted mutagenesis in vero cells induced by DNA damaging agent N-methyl-N-nitro-N-nitrosoguanidine(MNNG),the activation of c-Jun NH 2-terminal kinase/stress activated protein kinase(SAPK/JNK) pathway in vero cells induced by MNNG was studied. Western Blot analysis and Solid-phase kinase assay were used to measure the phosphorylation of JNK1 and kinase activity of JNKs, respectively. RESULTS: After 0.2 ?mol/L, 2.5 h MNNG or 1 mg/L, 1 h cycloheximide (CHM) treatment, the proportion of phosphorylated JNK1 in cell extract increased significantly, simultaneously the kinase activity of JNKs increased dramatically(6.7 and 3.0 folds respectively), as measured by the phosphorylation of c-Jun, a substrate of JNKs. CONCLUSION: Both 0.2 ?mol/L 2.5 h MNNG and 1 mg/L 1 h CHM treatment can induce the activation of JNK/SAPK pathway, one of the stress signal transduction pathways, in vero cells.

Obej ctive To investigate the role of metastasis associated protein 1(MTA1)in estrogen reg-ulated expression of matrix metalloproteinase -9(MMP-9)and tissue inhibitor of metalprotease -1(TIMP-1) in estrogen receptor( ER ) positive breast cancer cells .Methods MTA1 knockdown cell model was generated based on MCF-7breast cancer cell line by transfected with MTA 1-shRNA.The mRNA and protein level of MMP-9 and TIMP-1 in wild type MCF-7(MCF-7WT)and MCF-7MTA1-shRNA before and after 17β-estradiol ( E2) treatment were examined by Real -time PCR and Western blot respectively .Results The MTA1-shRNA showed maximally 84.9%suppression of MTA1 expression in MCF-7,suggesting a satisfied MTA 1 knockdown cell model was established for subsequent experiments .After treated with E2 for 48 h,MCF-7WT showed an incre-ment of 46%(P<0.05)and 37%(P<0.05)of the mRNA and protein level of MMP -9 and a decrement of 32.3%( P<0.05)and 18.2%(P<0.05)of TIMP-1;MCF-7MTA1-shRNA showed a decrement of 32.3%(P<0.05)and 18.2%(P<0.05)of mRNA and protein expression of MMP -9 respectively but no significant differ-ence in TIMP-1 comparing with MCF-7WT before treated with Estradiol.After E2 treatment,MCF-7MTA1-shRNA didn′t show significant change of MMP -9 except decrements of 32.3%(P<0.05)and 18.2%(P<0.05)in the mRNA and protein levels of TIMP -1.Conclusion MTA1 may be involved in the pathway by which estrogen regulated the expression of MMP -9 but not TIMP-1 in ER positive breast cancer cells .

Objective To investigate the change of plasma marinobufagenin (MBG) level and the expression of its receptor Na+-K+-ATPase (NKA) in renal biopsy specimens of chronic glomerulonephritis (CGN) patients. Methods Twenty-eight CGN patients and 14 healthy people were enrolled in the study. The plasma MBG concentration was measured by competitive inhibition ELISA system. Immunofluorescence and immunohistochemistry staining were applied to detect the expression of NKA in renal biopsy specimens of 28 CGN patients and analyzed by semi quantitively. Results Compared with healthy controls, CGN patients had significant lower plasma MBG concentration [(0.579±0.214) nmol/L vs (0.715±0.154) nmol/L, P＜0.05], without further significant difference between CGN patients with hypertension and with normal blood pressure [(0.595±0.231) nmol/L vs (0.557±0.197) nmol/L, P＞0.05]. Meanwhile, proximal tubular staining of NKA was decreased compared with normal controls. The NKA positive staining area of the CGN group was lower than that of normal controls [2.1% (0.5%-6.2%) vs 5.6% (3.5%-10.8%), P＜0.01] and correlated with 24-hour urinary sodium excretion (r=0.551, P＜0.01).Conclusion Decreased plasma MBG level and its receptor expression on proximal tubules may play a role in the regulation of sodium in CGN.

Objective To observe the clinical effect of compound remifentanil etomidate on gastrointestinalendoscopy and treat-ment among aged patients .Methods Divided 400 aged patients who got painless gastrointestinalendoscopy and treatment into two groups ,where one was observation group(200 aged patients) that got compound remifentanil etomidate ,while the other was control group which got fentanyl combined propofol .Compared and observed two groups on oxyhemoglobin saturation ,heart rate ,systolic-pressure ,diastolic pressure ,incidence of adverse reaction ,recovery time ,and time of leaving operating room .Results There was no obvious difference between observation group and control group on oxyhemoglobin saturation ,heart rate ,systolicpressure ,diastolic pressure before examination(P>0 .05);while there was distinct difference between examining and reviving ,which showed statisti-cal significance(P<0 .05) .The incidences of bucking ,dysphoria ,respiratory depression ,nausea and vomiting ,and dizziness in the two groups respectively were 3% 、2% 、5% 、3% 、11% and 8% 、11% 、13% 、8% 、27% ,which indicated the incidence of adverse reac-tion in observation group was obviously lower than that of control group ,where there was statistical significance (P<0 .05) .The time of recovery and the time of leaving operating room in two groups respectively were (3 .5 ± 1 .3)min、(9 .5 ± 1 .5)min and (7 .5 ± 3 .4)min、(18 .5 ± 4 .6)min ,which showed the time of observation group was lesser than that of control group ,where there was sta-tistical significance(P<0 .05) .Conclusion During the gastrointestinalendoscopy to aged patients ,compound fentanyl etomidate was safety ,less adverse reaction ,efficiency ,and strong controllability .

AIM: To assess the changes of macular thickness of acquire immunodeficiency syndrome ( AIDS) patients.
METHODS:The study based on the data analysis of 38 human immunodeficiency virus ( HIV ) positive patients ( 64 eyes ) . According to CD4 count and whether cytomegalovirus retinitis ( CMVR) happened, the patients were divided into 3 groups. Group A included 16 patients (32 eyes), in which CD4 count was < 50cells/μL and CMVR did not happen. Group B included 10 patients ( 20 eyes), in which CD4 count was>50cells/μL and CMVR did not happen. Group C included 12 patients (12 eyes), in which CD4 count was < 50cells/μL and CMVR just happened. Group D included 10 healthy people ( 20 eyes ) , as normal control group. By using optical coherence tomography ( OCT ) , thickness of retina along with a 1mm diameter circle centered on macular was evaluated.
RESULTS:The mean foveal thicknesses in groups A, B, C and D were 254. 03±15. 63μm, 263. 11±17. 12μm, 304. 50±50. 62μm and 257. 64±8. 54μm in order. Compared with foveal thickness in each group, there were significant differences in general (F=12. 933, P=0. 000). The mean foveal thickness in groups CMVR increased, which was of significant difference (P= 0. 000), compared with other groups.
CONCLUSION: CMVR can impair the structure and function of macular, which then seriously affects the visual function of patients. It's helpful to understand the progress and prognosis of CMVR disease by observing macular structure with OCT in early time.

Objective To explore the features of high-frequency ultrasonography and contrast-enhanced ultrasonography (CEUS) of papillary thyroid microcarcinoma (PTMC).Methods The CEUS data and ultrasound data of 147 PTMCS which were reconfirmed by pathology were analyzed retrospectively,and the CEUS and ultrasonic characteristics of them were summarized.Results Among 147 nodules,144 (97.9％) nodules were hypoechoic,and 3 nodules were isoechoic.Vague edge was found in 136(92.5％) PTMCs,and 126(85.7％) PTMCs were irregular in shape.Totally 92(62.6％) PTMCs were A/T ＞ 1,microcalcifications were found in 81 (55.1％) PTMCs.Besides,26(74.2％) PTMCs were found microcalcification in 35 PTMCs combined with Hashimoto's thyroiditis (HT),while 55 (49.1％) PTMCs were found microcalcification in 112 PTMCs combined with HT.There were significant differences between them (P ＜ 0.05).The blood distribution of 129 (87.8％) nodules was type Ⅱ.The contrast-enhanced pattern of 147 (100.0％) PTMCs showed in-homogeneous enhancement in 144 (97.9％) nodules,hypoenhancement in 136(92.5％) nodules,and all the nodules without amicula.Conclusions The typical PTMCs are hypoechoic,irregular shapeand vague edge,usually were found as A/T ＞ 1,microcalcification,and type Ⅱ blood distribution.With the method of contrast-enhanced ultrasonography,these nodules usually without amicula showed inhomogeneous and hypoenhancement.The incidence of microcalcification is more common when patients with Hashimoto's disease coexisting PTMC.

Objective To explore the main factors affecting medical expenses of patients with colorectal cancer(CRC)and reduce such expenses by optimizing the clinical pathway of CRC according to the influencing factors.Methods Data of 467 discharged and medical insured CRC patients at Shanghai Cancer Center,Fudan University,were collected from 2009 to 2010.A multiple linear regression model was applied to analyze the influencing factors of medical expenses.The clinical pathway of CRC was optimized,and medical expenses before and after optimization were compared.Results Our data found days of stay and complications had impact on the medical expenses.Also,medical expenses were decreased accordingly with optimization of clinical pathway of CRC.Conclusion This study provides evidence for decision-making on single disease payment and medical insurance compensation on CRC.It is also meaningful to reduce the economic burden of patients with CRC.

In order to prepare the recombinant vasoactive intestinal peptide (VIP) using intein mediated rapid purification system,the cDNA encoding the recombinant VIP was designed and synthesized according to the preference of E.coli,and then was cloned into the expression vector PTWIN. The recombinant plasmid PTWIN-VIP was transformed into expression host E.coli strain ER2566.The fusion protein consisting of the recombinant VIP,intein and chitin binding domain was expressed and purified by chitin affinity chromatography. The target peptide was released from the fusion protein by changing the temperature and the pH of the cleavage buffer. The molecular weight of the recombinant VIP was determined by the mass spectrometry and the results was conformity with the theoretical value. The preliminary bioactivity assay indicated that the recombinant VIP decreased the serum resistin levels significantly in LPS-induced acute inflammation. The preparation and the characterization of anti-inflammatory effects of the recombinant VIP layed the foundation for its further application.