Three basic functions of the working principle of Caritational Ultrasonic Surgical is introduced:ultrasonic emulsification, ultrasonic incise homeostasis and ultrasonic sterilization and debridement. As a new-style surgical equipment, it is widely used in clinical operations, upgrading interrelated medicine technology. The basic structure, working principle, main characteristics and clinical applications are introduced, thus redounding to broadening the knowledge of doctors and nurses in the safe operation of the machine.

Objective: To study the clinical manifestations of the head and neck angiosarcoma and the re-lationship of the staging with clinical treatment and prognosis. Methods: The clinical data of 21 patients with head and neck angiosarcoma treated in our hospital between January 1993 and January 2008 were retro-spectively analyzed. By studying the medical records of all patients and reviewing the related literatures, we discussed the clinical manifestations of these patients and the relationship of staging with clinical treatment and prognosis of head and neck angiosarcoma based on soft tissue sarcoma staging of AJCC2002' 6th. SPSS 17.0 software was used for statistical analysis. We calculated the survival rate using Kaplan-Meier method and compared the survival curves using log rank test. Results: Among these 21 cases, 10 were treat-ed with non-combined treatment, and the other 11 cases were treated with combined treatment. There were 6 stage Ⅰ cases, 3 stage Ⅱ cases, 1 stage Ⅲ case, and 11 stage Ⅳ cases. The 1-, 3-, 5- and 10-year total sur-vival rates were 72.2%, 41.3%, 27.5% and 13.8%, respectively. The average time of recurrence or metastasis was 4 months. Twelve cases had local recurrence (accounting for 57.1%), and 11 cases had distant metasta-sis (accounting for 52.4%). The metastatic sites included lymph node in 5 cases, lung in 4 cases, liver in 1 case, and bone in 1 case. Different treatment modalities (χ~2=8.31, P=0.004) and tumor staging (χ~2=9.74, P=0.002) were prognostic factors. Conclusion: There are no unified treatment strategies for angiosarcoma of the head and the neck. The overall prognosis is still not ideal. Biological treatment has been applied to clinical practice. Preoperative combined treatment has positive results. Tumor staging is an important factor affecting the prognosis. Surgery-based combined treatment can improve patient survival.

Objective To compare the efficiency and safety of clopidogrel of different loading-dose in acute coronary syndromes(ACS) patients with percutaneous coronary intervention(PCI) therapy, and, give an assessment of security about higher loading dose of clopidogrel. Methods 120 patients from January 2008 to January 2009 in our hospital were included.They were randomly divided into 3 groups(na=nb=nc=40)and were given 600 mg,450 mg and 300 mg clopidogrel on the 6 hour before PCI. There was no significant difference between the three groups' basic clinical information(p>0.05),such as age, sex and so on. Four points were selected to observe: the platelet aggregation induced by ADP with 5umol/L before and two hours、four hours, six hours after taking medicine; Primary endpoint events, which include shock during hospitalization, death, target revascularization, myocardial infarction, recurrent angina, stroke in 30 days,and Postoperative Bleeding events and adverse Reactions after Surgery in 30 days. Results compared to the standard dose of 300 mg clopidogrel, 600 mg doses clopidogrel can give a greater degree of inhibition on platelet activating than 450 mg doses in the pre-6 h after administration. Increase Clopidogrel loading dose can reduce the occurrence of major cardiovascular events rate. Bleeding events and the occurrence of adverse events was no significant difference among three groups. Conclusions compared to the standard dose of 300 mg clopidogrel, a higher loading dose of clopidogrel can produce much more faster, greater platelet inhibition, and similar security.

AimTo study the effect of extracts of ginkgo biloba leaves(GbE) on apoptosis in neuronal cells. Methods Primary cerebral cultures from rat fetus were used to observe the activity of neuronal cells and to determine the release of LDH and DNA gel electrophoresis. Results Gb E enhanced the activity of neuronal cells, decresed the release of LDH,and relieved the structural changes of nucleus and DNA fragmentation. Conclusion GbE can inhibit apoptosis in neuronal cells.

Aim To study the effect of extracts of ginkgo biloba leaves(GbE) on apoptosis in neuronal cells. Methods Primary cerebral cultures from rat fetus were used to observe the activity of neuronal cells and to determine the release of LDH and DNA gel electrophoresis.Results GbE enhanced the activity of neuronal cells, decresed the release of LDH,and relieved the structural changes of nucleus and DNA fragmentation. Conclusion GbE can inhibit apoptosis in neuronal cells.

Aim To observe the effect of extracts of ginkgo biloba leaves(GbE) on platelet adhesion and thrombosis. Methods The platelet adhesion was assayed by rotating glass-globe method. The thrombogenesis method in artery-vein bypass was applied to observe thrombosis in vivo. The Chandler method was applied to induce thrombosis in vitro.The tail bleeding time was recorded by shearing tail method.Results GbE significantly decreased platelet adherence rate in rabbits, decreased the weight of thrombus produced in artery-vein bypass in rabbits, shortened the length and reduced dry weight of thrombus of rats in vitro,prolonged the tail bleeding time in mice.Conclusion GbE inhibits the platelet adhesion and thrombosis.

Objective To investigate whether and what staining techniques are applied to the ultrathin sheet plastination slice and whether the stained specimen is of autofluorescences .Methods A cadaveric hand block was plastinated and then sectioned as a series of 300-400μm thick transverse sections .A total of 56 slices in total .Alternative sections were stained with hematoxylin -eosin staining ( HE) , Verhoeff -Van Gieson staining ( VVG) or methylene blue and azureⅡstaining(MA).The stained slices were examined under a light microscope and a confocal microscope .Results The plastinated slices were stained with the three staining methods .HE staining revealed the muscle and connective tissues were red or violet , bone was violet or blue;VVG staining showed the elastic fibers was black , the collagen was red , and other tissues were yellow .MA staining showed the tendon was violet , the bone was pink , cartilage was violet , and other tissues were purple.However, the intracellular structures appeared not very well stained .The collagen, elastin and muscular structures in the stained slices were observed under a confocal microscope .Conclusion The commonly used histology staining methods can be used to stain the ultrathin sheet plastination slices .The staining provides a better observation of various tissues in the slice than the unstained slice .After staining, those autofluorescent structures in the plastinated slice are detectable under a confocal microscope .

Objective To summarize the experience in the treatment of Marfan syndrome of pregnancy complicated with acute type A aortic dissection.Methods Three women with Marfan syndrome of pregnancy complicated with acute type A aortic dissection were treated.The average age was 28.6 (25-31) years,and the average gestational age was 36.5 (32-38) weeks.At first caesarean operation were performed under general anesthesia.Bentall + Sun' s operation was performed under deep hypothermic circulatory.After operation,the mother and fetus were followed up.Results Three women and their fetus were safe.The average extracorporeal circulation time,aorta clamp time and circulatory arrest time were 265 (210-280) min,135 (120-160) min and 26.5 (20-29) min,respectively.After a mean follow-up of 2.0 (1.0-2.5) years,3 patients were living well.CT angiogram detected normal aortic,with no signs of distal dilation.Three fetus were normal in development and neurocognitive function.Conclusion Methods of surgical repair and fetal delivery should be chosen based on aortic pathological changes and gestational age to maximize the safety of the mother and fetus.

Objective:To investigate the role of alloreactive T cell in clonal deletion and regulatory T cells ( Treg) in transplant tolerance.Methods:F1 mice were bred by crossing female BALB/c mice and male C57BL/6 mice.Within 24 h,newborn C57BL/6 mice were inoculated with F1 spleen cells via the orbital branch of the anterior facial vein.Six weeks later,the mice were subjected to F1 skin grafting to evaluate their tolerance.Proliferation,flow cytometry and adoptive transfer assay were used to analyze clonal deletion of alloreactive T cells and the expression of CD4+Foxp3+T cells in neonatal treated mice.Results: Newborn C57BL/6 mice injected with F1 splenic cells could induce transplantation tolerance,the level of tolerance was associated with the dose of splenic cells.3×107 splenic cells from F1 mice could induce long-term skin graft acceptance in C57BL/6 mice ,1×107splenic cells significantly prolonged the survival of F1 skin grafts,but the grafts completely rejected within 50 days.The mixed lymphocyte reaction ( MLR) experiment in vivo showed that alloreactive T cell in long-term tolerant mice was deleted completely,but a certain amount of reactive T cells existed in the low-dose group mice.Flow cytometry ( FCM) analysis showed that the expression of CD4+Foxp3+T cell in the high-dose group and low-dose group mice had no obvious difference compared with the naive mice.When alloreactive T-cells were injected into tolerant mice,the skin graft rejection was observed,and Treg cells upregulated in graft-rejected mice.Conclusion:The degree of transplantation tolerance depended on the clonal deletion of alloreactive T cells,instead of on the expression of CD4+Foxp3+Treg cells.CD4+Foxp3+regulatory T cells upregulated in graft rejected mice,which may be served as a negative feedback mechanism to control the intensity of rejection.

Objective To evaluate the clinical value of real-time 3 dimensional echocardiography (RT-3DE) for measurement of right ventricular function in the repaired tetralogy of Fallot (TOF) compared to cine magnetic resonance imaging (c-MRI).Methods Thirty-seven randomly selected patients with repaired TOF from Jan.2000 to Jun.2007 in Children's Hospital,Fudan University underwent both RT-3DE and c-MRI for the data of right ventricular enddiastolic volume (RVEDV),right ventricular end-systolic volume (RVESV),right ventricular ejection fraction (RVEF),which were compared to evaluate the reproducibility and correlation of two ways on right ventricular function.Results All the patients completed both RT-3DE and c-MRI on the same day.The correlation for RVEDV,RVESV,RVEF measured by 2 methods was high (r =0.933,0.943,0.911,P =0.000,0.000,0.105),and it showed that consistency existed in RVEF,as difference was only (1.2 ± 4.5) ％.Comparison with c-MRI,RVEDV and RVESV measured by RT-3DE was underestimated,in which difference was (-17.4 ± 16.9) mL,(-9.3 ± 10.5) mL.Conclusions RVEF with RT-3DE can be assessed with acceptable accuracy,but it is not so good for RVEDV and RVESV.Further study needs to be performed to make sure the value of RT-3DE on the assessment of right ventricular function in repaired TOF.