Objective To evaluate the effect of permissive hypercapnia on pulmonary function and in-flammatory responses of the collapsed lung of patients underwent video-assisted pulmonary lobectomy after one-lung ventilation.Methods Fifty patients,aged 38-65 years,ASA Ⅱ or Ⅲ,including 30 males and 20 females,scheduled for video-assisted pulmonary lobectomy were selected and divided into two groups ran-domly,with 25 patients in each group.During the surgery,PaCO2 of patients in group C were maintained during 35 to 45 mm Hg,while in group H the value were 55 to 65 mm Hg.The arterial blood samples were collected at 1 min before one-lung ventilate (T1 ),30 min after one-lung ventilate (T2 )and 30 min after re-flow of the collapsed lung (T3 )for arterial blood gas analysis,then the respiratory index of each patient was evaluated.Peripheral venous blood and bronchoalveolar lavage fluid draw from left lower lobar of the col-lapsed lung were collected to evaluate the levels of TNF-α,IL-6,and IL-10 at T1 ,T2 and T3 .The peak in-spiratory pressure,plateau pressure and tidal volume were also recorded to calculate lung dynamic compli-ance.Results Compared to group C,peak inspiratory pressure of group H was significantly higher;the IL-10 level of bronchoalveolar lavage fluid of the collapsed lung and the pulmonary dynamic compliance of group H were significantly higher at T2 and T3 ,and the concentrations of TNF-α,IL-6 of bronchoalveolar lavage fluid,the peak pressure,and respiratory index of group H were lower significantly at the same point of time (P <0.05).Conclusion Permissive hypercapnia would inhibit inflammation response of collapsed lung after one-lung ventilation effectively,improve lung diffusion capacity and pulmonary compliance.

To analyze clinical, neuro-electrophysiologocal, imaging and pathological characteristics of Hirayama disease (HD) and review its relevant literatures to improve its diagnosis. Clinical data of two HD cases admitted to Fujian Provincial Hospital, Fuzhou during 2005 to 2008 were analyzed with literatures review. HD occurred more in males, often onset at their adolescence with muscular weakness and atrophy in one or two upper limbs, but without sensory dysfunction or pyramidal signs. Neuro-electrophysiology showed neurogenic abnormality in the body areas dominated by the 4th cervical vertebra to the 1 st thoracic vertebral (C4-T1) spinal nerves in all the patients. Magnetic resonance imaging (MRI) showed slight atrophy of the lower cervical spinal cord at routine position and its compression and forward displacement to varied extent at flexion position, with posterior epidural capsular space widening, crescent or striped high signal, and voids of vessels in some patients. Enhancement magnetic resonance scanning showed crescent sign enhanced in some patients. Biopsies of the inflicted muscles appeared slight neurogenic abnormality in some cases, and normal in other cases. HD is rarely seen clinically, but it can usually be diagnosed according to its symptoms, neuro-electrophysiology and MRI.

The paper analyzes the deficiencies of the traditional Hospital Information System (HIS),establishes the hospital data mining and analysis platform,introduces the platform architecture,builds the data mining models themed by analysis of hospital leaders,supervision and management of antibacterial drugs,analysis of hospital quality,analysis of single disease,expenditure control by medical insurance,etc.,and puts forward the smart solutions to improve the service tevel of hospitals on the basis of above.

Objective To investigate the value of quantitative on analysis of argyrophil nucleolar organizer regions(AgNOR),carcinoembryonic antigen(CEA)and ferritin(Ft) for differentiation diagnosis of benign and malignant serous cavities effusion.Methods HPIAS-2000,a highly-clear image analysis system,was used to quantify 12 parameters of AgNOR particles of falling-off cells from 57 cases of benign and malignant serous cavities effusion.The shapes of AgNOR were observed and sorted.Meanwhile,CEA and Ft were examined with chemiluminescent assay.Results Among 12 parameters of AgNOR quantification,9 parameters were significantly distinct between benign and malignant serous cavity effusion(P

OBJECTIVE：To observe effect of L-NAME on apoptosis in the gerbil hippocampus after recirculation following ischemia.METHOD：Bilateral occlusion of common carotid arteries and TUNEL stain methods in gerbitil hippocampal tissue slice were used.RESULTS：L-NAME inhibited apoptosis in the CA1 subfield.CONCLUSION:Endogenous NO mediated apoptosis is inhibited by the L-NAME.

Objective To discuss the feasibility of the lung transplantation as an effective treatment for end-stage pulmonary diseases domestically and to compare the major issues involving the practice of lung transplantation domestically and overseas.Methods After the foundation of group of lung transplantation in May 2002, lung transplantation models of porcine were set up. From September 2002 to April 2005, in the 18 cases undergoing lung transplantation, there were subjected to single-lung transplantion (SLT, 83.3%) and 3 bilateral sequential single lung transplants without CPB (DSSLT, 16.7%). Indications for SLT (n=15) included emphysema (n=9), pulmonary fibrosis (n=3), pneumosilicosis (n=1), lymphangioleiomyomatosis (n=1) and ventricular septal defect (VSD) induced Eisenmenger's syndrome (n=1); for DSSLT (n=3) bronchiectasis (n=1) and pulmonary emphysema (n=2). Among the 15 SLTs, there were 9 cases of left SLT and 6 right SLT. Among them, 2 cases shared one same donor's lung block, one case received contralateral lung transplantation―a left donor lung implanted in the recipient’s right thorax, and one case simultaneous right SLT and VSD repair. Results In hospital mortality (HM) was 3/18 ( 16.7%). Among SLTs, early death was due to severe rejection on the 30th postoperative day in one patient and acute rejection on the 15th postoperative day in other patients, and another patient died due to pulmonary vein embolism on the 36th day. There were 3 and 2 patients with the survival time longer than 1 and 2 years respectively. The median overall survival was 10 (2 to 32) months. Conclusions Our LT program shows similar results to those reported by the International Society for Heart and Lung Transplantation for developed countries. The key of successful operation depends on the establishment of group of lung transplantation and cooperation of multi-department. Ischemic-reperfusion injury, acute-rejection and infection are the major reasons of deaths shortly after the operations.

Objective To assess the efficacy of interventional bronchoscopic techniques used to treat stenosis of bronchial anastomosis after lung transplantation.Methods A retrospective study of 24 cases who underwent lung transplantation from September 2003 to August 2005 in our Unit was done. All recipients were subjected to surveillance bronchoscopy with biopsy at predetermined intervals and when clinically indicated. Endobronchial electrocauterization with microwave therapy apparatus and endobronchial electrocoagulation with high-frequency electrotome were performed for the management of bronchial stenosis or granuloma formation.Results There were 2 of 24 recipients (2/24,8.3 %) with stenosis of bronchial anastomosis. Airway stenosis appeared in 3 of 28 anastomoses (3/28,10.7 %): 2 on the left and 1 on the right. These patients with airway stenosis responded to interventional bronchoscopy,and their respiratory function was improved significantly.Conclusions Despite the improvements in surgical technique and immunosuppression strategies,a small number of patients still had airway complications after lung transplantation. Interventional bronchoscopic techniques,i.e. endobronchial electrocauterization with microwave therapy apparatus and endobronchial electrocoagulation with high-frequency electrotome will be effective in the treatment of airway complications after lung transplantation and with good response in respiratory function.

Objective To evaluate the role of astrocyte chemokine (C-C motif) ligand 2 (CCL2) in microglial activation in an in vitro experiment.Methods Primary astrocytes and microglias were isolated from the brain tissues of C57BL/6J mice at postnatal day 1-2.The experiment was performed in two parts.Experiment Ⅰ Astrocytes were inoculated in 6-well culture plates at a density of 3 × 104 cells/well (2 ml/well) and divided into 5 groups (n=3 each) using a random number table:control group (group C),tumor necrosis factor-alpha (TNF-cα) group,1 μg/ml CCL2 small interference RNA (siRNA) group (group CCL2-siRNA1),2 μg/ml CCL2-siRNA (group CCL2-siRNA2) and negative control siRNA group (group NC-siRNA).Astrocytes were cultured routiuely in group C,and 10 ng/ml TNF-α was added and astrocytes were incubated for 15 min followed by washout with phosphate buffer solution (PBS),and then astrocytes were incubated for 3 h in the other 4 groups.At 24 h before TNF-α was added,CCL2-siR-NA 1 and 2 μg/ml were added in CCL2-siRNA1 and CCL2-siRNA2 groups,respectively,and NC-siRNA 2 μg/ml was added in group NC-siRNA.The concentrations of CCL2 were determined by enzyme-linked immunosorbent assay.Experiment Ⅱ Microglias were inoculated in 6-well culture plates at a density of 3×104 cells/well (2 ml/well) and divided into 3 groups (n=3 each) using a random number table:control group (group C),TNF-α group and CCL2-siRNA group.Microglias were cultured routinely in group C.In group TNF-α,10 ng/ml TNF-α was added to astrocytes which were incubated for 15 min followed by washout with PBS,astrocytes were then incubated for 3 h,and the supernatant was collected and added to microglias which were incubated for 24 h.In group CCL2-siRNA,2 μg/ml CCL2-siRNA was added to astrocytes which were incubated for 24 h,10 ng/ml TNF-α was also added to astrocytes which were incubated for 15 min followed by washout with PBS,astrocytes were then incubated for 3 h,and the supernatant was collected and added to microglias which were incubated for 24 h.The activity of microglias was measured by immunofluorescence,and the migration of microglias was evaluated by Transwell migration assay.Results Experiment Ⅰ The concentrations of CCL2 were significantly higher in TNF-α,CCL2-siRNA1,CCL2-siRNA2 and NC-siRNA groups than in group C (P＜0.05).The concentrations of CCL2 were significantly lower in CCL2-siRNA1 and CCL2-siRNA2 groups than in TNF-α and NC-siRNA groups (P＜0.05).There was no significant difference in CCL2 concentrations between group TNF-α and group NC-siRNA (P＞0.05).Experiment 1Ⅱ Compared with group C,the activity of microglias was significantly increased,and the migration of microglias was enhanced in TNF-α and CCL2-siRNA groups (P＜0.05).Compared with group TNF-α,the activity of microglias was significantly decreased,and the migration of microglias was weakened in group CCL2-siRNA (P＜0.05).Conclusion Astrocyte CCL2 is involved in mieroglial activation in an in vitro experiment.

Objective To evaluate the operative technique, perioperative management and outcomes of bilateral lung transplantation for idiopathic pulmonary artery hypertension. Methods There were 2 cases of idiopathic pulmonary hypertension subject to bilateral sequential lung transplantation with ECMO support (16, 17 years old, respectively). The pulmonary artery pressure was 10/70 and 148/72 mm Hg respectively. The heart function was NYHA Ⅳ, the operative procedure was right lung first, then left lung, and the cold ischemia time was 230 min/430 min and 185 min/300 min respectively. The ECMO support time was 550 min and 450 min respectively. The blood loss during the operation was 3000 and 1200 ml, respectively. Resuits The ECMO was withdrawn 16 and 13 h postoperation respectively. There was unstable hemadynamics and acute left heart failure on the 3rd and 4th day after the operation. The patients were treated with ventilate support and tracheotomy on 3rd and 6th day respectively. Additionally, the patients were given cardiotonic, dieresis and the ventilation was withdrawn on 33rd and 12th day after the operation respectively. They were discharged from the hospital on 93rd and 32nd day after the operation. The heart function both reached NYHA I, two cases were followed up for 25 and 10 months respectively.Both of them had an excellent quality life. Conclusion Bilateral lung transplantation is effective for end-stage idiopathic pulmonary artery hypertension even with slight right ventricular dysfunction with satisfactory short-term outcome. A limited operative time, an ECMO support for heart and lung during the peri-operative period and a perfect management for the left ventricular dysfunction after surgery are key roles for the success. Closed follow-up and surveillance are needed for long-term outcomes.