Objective To investigate the technique and feasibility of video-assisted thoracoscopic surgery (VATS) in the treatment of esophageal carcinoma. Methods Sixteen patients with esophageal carcinoma underwent esophagectomy by VATS between October 2002 and October 2003. The tumors were found in mid-segment in 13 patients and lower segment in 3 patients. Their TNM staging was: stage T 1 2 patients, stage T 2 5 patients and stage T 3 9 patients; stage Ⅰ 2 patients, stage Ⅱ 8 patients and stage Ⅲ 6 patients. Results No conversion to open surgery was required. The operation time of VATS was 90～150 min (mean, 110 min). The number of removed mediastinal lymph nodes was 6～14 (mean, 7.3). Drainage tube was taken out 2～3 days after operation and the drainage volume was 300～600 ml. No complications were seen. Conclusions VATS for esophageal carcinoma is feasible. Indications for VATS should be stage Ⅰ～Ⅱ and in addition no outward infiltration (≤stage T 3).

Diabetic retinopathy (DR) is a common disease of ophthalmology,often causes irreversible decline of patients' vision,which has two features including macular oedema,diabetic retinal neovascularization.Diabetic retinal neovascularization is one of the most important reasons leading to blindness.Endostatin (ES) is one of the most effective agents inhibiting angiogenesis,whose biological function has a close relationship with its chemical construction.However,its mechanisms of treating diabetic retinal neovascularization are very complicated and remain unclear.Therefore,in this review we summarized several possible mechanisms,including regulating the expression of extracellular matrix,inhibiting the expression of pro-angiogenic factors,and regulating the signaling pathways,by which ES may inhibiting diabetic retinal neovascularization.

The effects of low-level radiation on cAMP in peasma, adrenal and testis and cGMP in adrenal of rats were studied. Adult male rats were given whole-body irradiation with x-rays at a dose rate of 15 mGy/min. They were irradiated with 50 and 100 mGy daffy for 30 days within 5 weeks with cumulative doses of 1.5 and 3.0 Gy respectively. One, two and four weeks after termination of irradiation, the levels of cAMP in plasma, the adrenal gland and testis, the level of cGMP in the adrenal gland and the weights of the body, testes and pitutary were examined. The weights of testes decreased within 4 weeks after irradiation as compared with the control and the level of cAMP in the testis was significantly increased at weeks 1 and 2 in the 3.0 Gy group. At week 4, it returned to near normal. In another experiment, animals were irradiated with ~(60)Co ?-ray at a dose rate of 45.3?Gy/min, 16.3 mGy/6h/day and 6 days per week. At 6, 10, 14, 18 and 22 weeks, with cumalative doses of 0.59, 0.98, 1.37, 1.76 and 2.15 Gy respectively, the levels of cAMP in the pitutary and testis and testicular weight were quantified. No significant changes were found. These results suggest that dose rate is an important factor In the determination of the degree of damage of the testis following low-level irradiation.

The paper discusses the basic contents, characteristics, and development trend of training programs abroad for high level hospital administrators as represented by MHA (Master of Hospital Administration) programs. Those programs establish curricula and training modes in light of the primary tasks and responsibilities of high level hospital administrators. They attach importance to the cultivation of concepts of macro health and ideas of modern management, provide training in methodologies of public health as represented by bio statistics and epidemiology, emphasize practical matters of operation and management such as hospital planning, quality control and financial accounting, and make wide use of case studies so as to enhance the abilities to solve practical problems. Hospital reform and development make it imperative to improve the training of high level hospital administrators, which must be properly oriented, and to develop domestic MHA programs with Chinese characteristics by utilizing existing resources of health administration education and integrate relevant courses.

Abstract BACKGROUND: Recently, microcarrier culture as a high concentration cel culture technology has been used in hepatocyte culturein vitro. OBJECTIVE:To periodicaly observe the morphological changes of human hepatocyte L-02 cultured by the spherical porous chitosan microcarrier. METHODS:The self-made spherical porous chitosan microcarrier sample as a support to culture human hepatocytes L-02 acted as experimental group; non-spherical porous chitosan microcarrier as a support to culture human hepatocytes L-02 as control group. Cels in two groups underwent cel count at regular time, and the morphological changes were observed in the experimental group, including inverted phase contrast biological microscope observation and scanning electron microscope observation. RESULTS AND CONCLUSION:The quantity of cultured cels in the two groups was increased in the first 3 days and reached the peak at the 3rd day. The cel quantity in the experiment group was obviously higher than that in the control group (P < 0.05). There was no significant difference in the three samples of the experimental group (P > 0.05). The quantity of hepatocytes adhered to the microcarrier surface was gradualy increased in the former 3 days under the inverted phase contrast biological microscope. There were lots of cel clusters on the surface of a greater part of microcarriers, with the total survival rate of more than 90%, and hepatocytes kept a good morphological structure. Under the scanning electron microscope, lots of hepatocytes adhered tightly to each other on the surface and section of microcarrier as wel as inside the microcarrier. It is indicated that the self-made spherical porous chitosan microcarrier as a support in three-dimensional environment can undergo cel culture with high concentration.

Objective To investigate theeffect of the one-lung ventilation (OLV) on open heart surgery with right subaxillary minimally invasive small incision in infants. Methods We conducted a retrospective analysis of 316 infants undergoing open heart surgery through right axillary straight mini-thoracotomy in ourhospital from Jan-uary 2014 to December 2014. Ordinary tracheal tube was inserted into left bronchus during OVL in all patients. OLV with pressure-control mode was performed with FiO2 100% and I:E 1:1 ~ 1.5 and their respiratory rate and the pressure ventilation were adjusted to maintain SpO2 and ETCO2 in the normal range. Conventional ultrafiltration was performed after CPB and fluid restrictions were intraoperatively maintained. Blood samples were obtained for deter-mination of PaO2 and PaCO2 after induction of anesthesia (T1), at the time points: OLV 10 min (T2), OLV 30 min (T3), OLV10 min after CPB (T4) and the recovery TVL (T5). The HR, MAP, incidence of pneumothorax and me-chanical ventilation time were recorded and monitored as well. Result All patients lived through perioperative pe-riod, without pneumothorax. There were no significant differences in PaCO2, HR and MAP between time points. But PaO2 at the time point of T1 significantly lowerthan those at other time points of T2, T3, T4 and T5, but its indexes at all time points were in normal range. Conclusion The appropriate skills ofintubation, rational strategy of ventila-tion and intensive prevention of the lung may be good for the safe application of OVL in open heart surgery through right subaxillary minimally invasive small incision in infants.

BACKGROUND:Myocardial infarction patients commonly appear to have left ventricular remodeling and heart failure. Because of physical characteristics, these two complications are more likely to occur in elderly patients with myocardial infarction. In recent years, stem celltransplantation in the treatment of acute myocardial infarction and heart failure has become a hot topic, and the feasibility and safety has been confirmed, but its long-term outcomes in elderly patients are stil unclear.
OBJECTIVE:To assess the long-term effect of transplantation of autologous peripheral blood stem cells on the left ventricular remodeling and heart function in the old patients with myocardial infarction.
METHODS:Thirty old patients (age ≥ 60 years) with myocardial infarction were randomly assigned to receive intracoronary transplantation of peripheral blood stem cells fol owing bone marrow cells mobilization by granulocyte colony-stimulating factor ( 300-600μg per day) subcutaneously for 5 days in addition to conventional therapy (standard drug therapy and percutaneous coronary intervention;transplantation group, n=15) or standard therapy (standard drug therapy and percutaneous coronary intervention;control group, n=15) . Complications during intervention, left ventricular function and left ventricular remodeling at baseline and 6, 12, 24, 60 months after treatment were monitored.
RESULTS AND CONCLUSION:Left ventricular function, left ventricular end diastolic volume, and left ventricular end-systolic volume were significantly improved 6,12, 24, 60 months after autologous peripheral blood stem celltransplantation compared to baseline, while these parameters remained unchanged in the control group. These parameters had statistical difference between the two groups after treatment. During the fol ow-up, no severe side effects were observed. These findings indicate that autologous peripheral blood stem celltransplantation leads to significant and longstanding improvements in left ventricular performance of old patients with myocardial infarction, and shows good safety.

Objective This study was designed to evaluate the short-term effect and safety of 80 mg/d atorvastatin treating on ACS patients with interventional therapy in China. Methods From August 2002 to March 2014,1746 ACS patients accepting 80mg/d atorvastatin treatment were enrolled from three province hospital. All patients were divided into three groups, 886 patients in group A with 80mg/d atorvastatin treating for 4 weeks, 562 patients in group B with 80mg/d atorvastatin treating for 8 weeks, and 298 patients in group C with 80mg/d atorvastatin treating for 12 weeks after discharge. Blood lipid level, hepatic function, renal function and creatine kinase level were tested on 4th, 8th, 12th week. Results The percentage of patients reacting lipid levels was 85.0%in group A, 86.1%in group B, 94.0%in group C and 86.9%in total. The rate of ALT/AST exceed two times of normal upper level in group A was 1.6%, in group B was 1.8%and in group C was 1.0%.The symptom of joint and muscle pain in group A was 6.3%, group B was 1.4%, group C was 2.7%. The elevation of creatine kinase in group A was 0.8%, in group B was 0.5%, and 0%in group C. The symptom of abdomen discomfort in group A was 2.3%, group B was 2.5%and group C was 4.0%. The complaint of other symptoms was 3.2%in group A, 2.1%in group B, 1.7%in group C. Conclusions Accepting 80 mg/d atorvastatin treating for ACS patients with interventional therapy is effective and safe in short term.

BACKGROUND:Number of experimental and clinical studies have shown that stem celltransplantation can establish new blood vessels and improve heart function instead of necrotic myocardium, to significantly improved clinical symptoms and prognosis of cardiovascular disease patients.
OBJECTIVE:To observe the safety of human umbilical cord blood mononuclear cells transplantation in patients with coronary heart disease and heart failure.
METHODS:A total of 12 patients with coronary heart disease and heart failure (acute myocardial infarction and heart failure in six cases, old myocardial infarction and heart failure in six cases) were enrol ed in this study. Patients were treated on the basis of standard medication and percutaneous coronary intervention. The coronary pathway was established via a percutaneous catheter, and suspension of cord blood mononuclear cells was injected through microcatheter into the distal artery. Routine blood test was carried out at 1 week after celltransplantation, blood routine, liver function, kidney function, C-reactive protein, IgA, IgG were compared preoperatively and postoperatively.
RESULTS AND CONCLUSION:The incidence of adverse reactions in cord blood stem celltransplantation was 8.3%, including one case of fever. No micro-embolism occurred. During 1-week fol ow-up, no graft-versus-host disease appeared. After celltransplantation, there were no significant changes in blood routine, liver function, kidney function, C-reactive protein, IgA, IgG. These findings indicate umbilical cord blood monomuclear cells transplantation is safe in a short term for patients with coronary heart disease and heart failure.