Objective To evaluate the operative technique,perioperative management and ontcome of single lung transplantation and ventricular septal defect repair for Eisenmenger syndrome.Methods A 16 years old male patient with end-stage ventricular septal defect who received open heart exploration 12 years ago underwent right single lung transplantation and ventricular septal defect repair on Oct.22,2004.The operation was carried out under cardiopulmonary bypass(CPB) with beating heart.The donor lung was perfused with modified LPD solution.Tacrolimus(FK506),mycophenolate mofetil (MMF) and corticosteroid regime was used for immunosuppressive therapy.CPB time was 244 min,and donor lung ischemic time was 6 h.Results During the operation,the pulmonary artery pressure was reduced from 110/60 mm Hg to 53/39 mm Hg after transplantation.The patient weaned from the ventilator at the 12th postoperative day.An acute rejection episode occurred on the 14th postoperative day.ICU stay was 30 days.99m-Tc-MAA pulmonary perfusion scan demonstrated predominant right lung blood flow.UCG assessed improved heart functions,intact ventricular septum and mean pulmonary artery pressure of 45 mm Hg.The exercise tolerance was prominently improved.The patient was discharged on the 62nd day after transplantation.Conclusions Single lung transplantation and congenital heart defect repair is effective for end-stage left-to-right shunt congenital heart diseases with satisfying short-term results.Closed follow-up and surveillance are needed for long-term outcomes.

The current status of otolaryngology at the undergraduate stage teaching is:Too many curriculum contents,few theoretical and practical courses,students' lack of interest in study because they feel the contents difficult and so on.According to these situations,teaching reform has been carried out.The curriculum resource is divided into content-based curriculum resources and conditional resources.The current undergraduate teaching materials(Otolaryngology Head and Neck Surgery by People's Medical Publishing House,the Eighth Edition) is taken as its entry point,based on the current curriculum resources and its application situation in the teaching process.The study combines the teaching contents and curriculum resources and further explores the potential of curriculum resources and enlarges the resource space in order to explore the way and the method of using curriculum resource reasonably and efficiently,and construct the curriculum resources which have otolaryngology subject features and then guide teaching better.

Objective To investigate the expression and significance of TLR-2 and HO-1 in recurrent nasal polyps,and to discuss the relationship between the expression and the recurrence of nasal polyps. Methods The immune protein imprinting technology was used to detect the protein expression of TLR-2 and HO-1 in 20 cases of recurrent nasal polyps,20 cases of nasal polyps and 20 cases of normal mucosal tissue in control group, and the relationship between the two proteins were analyzed. Results Expression levels of TLR-2 and HO-1 in the tissues of the recurrent nasal polyps had statistically significant difference with nasal polyps group ( <0.05) . Expression levels of TLR-2 and HO-1 in the tissues of the nasal polyps had statistically significant difference with normal nasal mucosa tissues ( <0.05) .The expression of TLR-2 and HO-1 had significant correlation in each group ( <0.05) .Conclusion TLR-2 and HO-1 plays an important role in the recurrence mechanism of nasal polyps, and both of them may be as objective indicators for postoperative follow-up of patients with recurrent nasal polyps and judging the recurrent trend.

AIM: To investigate the antagonistic effect of zinc on hepatic ischemia- reperfusion (HIR) injury and the effect of zinc on the expression of adhesion molecules in rat liver to clarify the mechanisms involved. METHODS: After zinc supplementation (5 ?mol/kg bw,po) , the changes in hepatocellular morphology,ALT and AST activities in serum,MDA levels in serum,and expression of ICAM-1,VCAM-1 in liver of the animals subjected to HIR were examined. RESULTS: The results showed that HIR (30 minutes of ischemia followed by 90 minutes of reperfusion) significantly increased ALT, AST activities and MDA levels in serum. The destruction of hepatic structure was observed in HIR rats. In the mean time, the expression of adhesion molecule was enhanced.After zinc administration, ALT and AST activities in serum and MDA levels in serum were all decreased. The structure of hepatocyte was nearly normal.The further experiment showed that adhesion molecule expression was suppressed.CONCLUSION: These results indicate that zinc may protect liver against ischemia-reperfusion injury by inhibiting the production of free radicals and the expression of adhesion molecule.

Objective To explore the efficacy and safety of conversion from calcineurin inhibitor (CNI) to sirolimus (SRL) as major immunosuppressive therapy in lung transplant recipients.Method Retrospective analyses were conducted for the clinical data of all the patients undergoing lung transplantation in Wuxi People's Hospital between January 2011 and December 2014.Sixteen were given conversion treatment with Sirolimus in the postoperative irnmunosuppressive therapy.We analyzed the opportunity and reasons in the conversion treatment,and the safety,effectiveness and complications of the conversion treatment.Result The follow-up period was 8 to 25 months,and the median time of conversion was 6 months after operation (2-18 months).The indications of conversion concluded:malignant tumor (n =8),renal dysfunction (n =5),lymphangioleiomyomatosis (n =1) and intractable diarrhea caused by CNIs (n =2).Four cases suffered from interstitial pneumonitis associated with Sirolimus and one case suffered from spontaneous pneumothorax,and they all conversed back to CNIs.In those patients,cancer recurrence occurred in 4 cases (of them,there were 3 deaths),and 3 patients developed chronic rejection.Those recipients receiving the conversion treatment due to renal dysfunction showed recovery of renal function to some extent.Conclusion It's effective and safe to converse the immunosuppressive therapy based on Sirolimus.Sirolimus should be reduced or withdrawn when interstitial pneumonitis associated with Sirolimus occurred.

Objective To explore the expression of cadherin (Cad) genes in patients with chronic myeloid leukemia (CML),and to elucidate the significance of Cad genes in the development of CML.Methods E-Cad and N-Cad gene expression levels in bone marrow mononuclear cells (BM-MNC) from 48 CML patients (29 in chronic phase,19 in progressive phase) were detected by real time quantitative polymerase chain reaction (qRT-PCR).Results Gene expression of E-Cad and N-Cad was detectable in CML BM-MNC.E-Cad gene expression level was lower in progressive CML than that in chronic CML (0.20 ± 0.35 vs 1.19 ± 0.87,P ＜ 0.01),while N-Cad was highly expressed in progressive CML than in chronic CML (0.89 ± 0.45 vs 0.57 ± 0.47,P ＜ 0.05).E-Cad gene expression level was negatively corrclatcd with thc pcrccntagc of peripheral blood progenitor cells (r =-0.705,P ＜ 0.01).Conclusion E-Cad and N-Cad gene expression correlates with the progression of CML,and might be used as an evaluation index for disease development.

OBJECTIVE: To investigate the self-renewal mechanism of CD133+ cancer stem cells from Hep-2 cell line. METHOD: The CD133+ cells were sorted by flow cytometry from Hep-2 cell line. Then the sorted CD133+ cells were cultured in RPMI1640. The ability of self-renewal of CD133+ cells were tested by MTT assay. mRNA and protein expression of self-renewal related genes were detected by western blot and RT- PCR. RESULT: (3.10 ± 0.21)% of Hep-2 cells expressed the membrane antigen CD133. CD133+ fraction was raised to (90.20 ± 5.51)% by flow cytometry. In vitro culture and growth curve showed CD133+ cells had more active proliferation ability than CD133- cells, which showed statistically significant difference between these two group (P < 0.01). RT- PCR and western blot results showed upregulated mRNA and protein expression of Fas, c-myc, survivin in CD133+ group (P < 0.01). In the same time, the ratio of Bcl-2/Bax gene expression was obviously increased in CD133+ group. Self-renewal related gene such as β-catenin, SHH, SMOH and Bmi-1,Gli-1 were all up-regulated in CD133+ group both in mRNA and protein. On the contrary, PTCH gene was down-regulated. CONCLUSION CD133 positive cells are a small proportion of a Hep-2 cell line. The results of this experiment verified that CD133 positive cells owned the properties of cancer stem cells. Upregulated anti-apoptotic gene is the foundatiom of self-renewal mechanism of CD133+ cells. Cancer stem cells related signal pathways such as Hedgehog, Wnt and Bmi-1 pathway are in state of activation. The identification of self-renewal mechanism about cancer stem cell provides a powerful tool to investigate the tumorigenic process in the larynx and to develop therapies targeting to these signal pathways.
AC133 Antigen ; Antigens, CD ; Apoptosis ; Cell Physiological Phenomena ; physiology ; Down-Regulation ; Flow Cytometry ; Glycoproteins ; Humans ; Laryngeal Neoplasms ; Neoplastic Stem Cells ; physiology ; Patched Receptors ; Patched-1 Receptor ; Peptides ; Receptors, Cell Surface ; genetics ; metabolism ; Signal Transduction ; beta Catenin ; genetics

OBJECTIVE: To research the correlation between development of sphenoid sinus and age in normal children and adolescents by 3-D CT images. METHOD: Review of CT images of the skulls of 120 children and adolescents aged 0~20 years old. They were divided into five groups. Then reconstructed 3-D shape of the sphenoid sinus, and measureed the maximal anteroposterior diameter, longitudinal diameter, and transverse diameter of the bilateral sphenoid sinus by the 2-D and 3-D approach respectively, then process statistical analysis. RESULT: Pearson analyses revealed a positive correlation between various diameters of sphenoid sinus measured by 2-D and 3-D approach and age (P<0. 05). CONCLUSION The development of sphenoid sinus has a linear correlation with age, and increases with age and growth in Yunnan region. It helps to know the three-dimensional CT images of the sphenoid sinus in children and adolescents by Simplant software, thereby allow the clinicians to understand the current situation of the development of sphenoid sinus. Meanwhile, it contributes to preoperative evaluation of sinus problems.
Adolescent ; Child ; Child, Preschool ; China ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Infant ; Infant, Newborn ; Skull ; Software ; Sphenoid Sinus ; growth & development ; surgery ; Young Adult

ObjectiveTo observe the dynamic change of mtDNA in rats with lung ischemiareperfusion (IR) injury and the implications.MethodsThe rat model of lung IR injury was made.Thirty-two male SD rats were divided into IR group and control group.Each group was sub-divided into two subgroups.Thirty and 60 min after reperfusion,8 rats of each group were sacrificed; left lungs and whole blood were collected.Histopathological study of lung tissues were performed; wet weight/dry (W/D) weight ratio of the lung was detected; DNA was extracted from whole blood,and mtDNA level in circulation was detected by using real-time PCR; the protein levels of MMP-9 and MCP-1were examined by ELISA.Results(1) As compared with control group,the edema and PMN emigration were more serious in IR group; besides,the W/D ratio was increased progressively in IR groups as compared with control groups respectively (P＜0.01); (2) As compared with control group,the mtDNA in circulation was significantly increased 30 min after reperfusion (P＜0.01),and the same trend was detected 60 min after reperfusion (P＜0.01):(3) There was no significant difference between the two groups in the content of MMP-9 and MCP-1in the lungs 30 min after reperfusion (P＞0.05),but the MMP-9 and MCP-1expression levels were increased 60 min after reperfusion (P＜0.01).ConclusionThe mtDNA expression in circulation was increased in the early stage of lung IR,and the increased expression of mtDNA was earlier than the up-regulation of MMP-9 and MCP-1.Our results indicated that mtDNA may aggravate lung injury through increasing MMP-9 and MCP-1in the lung IR.

BACKGROUND: Osteolysis has always occurred in pelvis. Percutaneous injection of bone cement stabilized bone fracture, relieved pain or even treated tumor. However, leakage of bone cement might cause severe complications. OBJECTIVE: To explore the therapeutic effect of peroutaneous injection of bone cement on treating osteolysis pelvic disease in 9 cases by the CT guidance. METHODS: By the CT guidance, needing degree was determined firstly. Focal size and scanning layers were used to calculate focal volume and estimate injected dose of bone cement. Three-dimensional targeting device was used to introduce the puncturation. The bone cement which was 0.2-0.5 mL less than the calculated volume was injected into osteolysis site. The accuracy, injected dose, clinical efficacy, and complications were investigated. RESULTS AND CONCLUSION: The following-up ranged from 5 months to 4 years, with mean duration of 1.5 years. At 1-48 hours after operation, symptoms were recovered, including complete recovery (n=6), partial recovery (n=2), and light recovery (n=1). Leakage of bone cement was not detected out around focal region. This suggested that percutaneous injection of bone cement into the erosion site is an effective method to treat pelvic osteolysis disease, characterizing by security, effective, and less invasive.