Ojective To study the anesthesia technique for video-assisted thoracoscopic coronary artery bypass surgery (VATCABS). Methods The anesthesia of 14 VATCABS were reviewed retrospectively. Results The average dose of Fentanyl was (13.3?7 3)?g/kg Six (42.9%) of 14 cases were extubated at the operating room, while other 8 cases (57.9%) were extubated (4.71?2.21) hours after operation. The time of ICU stay was (45.2?35.5) hours. No anesthesia related complications were found perioperatively. Conclusions "Fast track" anesthesia technique is suitable for VATCABS.

Fifty-two patients with chronic thrombeembolism (41 male, 11 female) aged 33-67 yr underwent pulmonary endarterectomy between 1997-2008. Anesthesia was induced with etomidate, fentanyl/ sufentanil and rocuronium/vecuronium and maintained with large doses of narcotics supplemented with low concentrations of isoflurane/sevoflurane if necessary. Swan-Ganz catheter was placed after induction of anesthesia. Trausesophageal echocardiography was monitored. Bilateral pulmonary thromboembolism was performed using profound hypothermia with circulatory arrest. After operation, 35 patients still had sustained pulmonary hypertension (67%). Nervous system complications occurred in 7 patients ( 14% ). Six patients developed lung bleeding (12%) during and after operation and 4 patients infection (8%). The mortality was 15%.

From June 2004 to December 2005 anesthesia was done for 43 patients undergoing orthotopic heart transplantation (OHT) in Fuwai Hospital. Most patients were premedicated with oral diazepam 5-10 mg, and intramuscular morphine 0.2 mg?kg-1 and scopolamine 0.1-0.3 mg. Radial artery was cannulated and Swan-Ganz catheter was placed. ECG, direct BP, HR, CVP, PAP, CO, SpO2, SvO2, PETCO2 were monitored before and during operation. Anesthesia was induced with midazolam 1-3 mg, etomidate 0.2-0.3 mg?kg-1 , fentanyl 5-15?g?kg-1 or sufentanil 50-100?g, vecuronium 0.1 mg?kg-1 or rocuronium 0.6 mg?kg-1 , and maintained with isoflurane inhalation and propofol infusion and intermittent i. v. boluses of fentanyl or sufentanil and vecuronium. Hemodynamic suppression was mild during anesthesia. The average duration of aortic cross-clamping and CPB was 57-133 min and 123-230 min. The cardiovascular support used for weaning the patients from CPB included dopamine, ephedrine and isoproterenol. Nitroglycerin, NO and iloprost were administered for pulmonary artery vasodilation. Pacing was started at the termination of CPB because of bradycardia in 1 of 43 patients. Sinus rhythm appeared after the patients were weaned from CPB and the function of the transplanted heart was satisfactory. Basiliximab, cyclosporine A, cellcept and methyl prednisolone were administered for immunosuppression during perioperative period. Forty-two of the 43 patients were discharged from hospital without any rejection episodes or other complications. One patient died of multiple organ failure after heart-kidney transplantation.

This study was designed to establish methods to measure partition coefficients of inhaled anesthetics at 1 atmosphere and 37 C by using syringe-flask double equilibration technique. Olive oil/gas (O/G), saline/gas (S/G), and water/gas (W/G) partition coefficients of isoflurane were 90.20?2.01, 0.6256?0.109, and 0. 741?0.025, respectively. Even though O/G was 150 folds of S/G,coefficients of variation for both O/G and S/G were less than 3%. The results indicate that the established double-equilibration technique has a very high repeatability and is applicable to wide ranges of inhaled anesthetics' solubilities.

Objective To explore the efficacy of autologous pleural patch in surgical operation on the patient with chronic tuberculous empyema.Methods Autologous pleura patches were used to repair the pulmonary wound in the surgical operations for 7 patients with chronic tuberculous empyema,who received surgical management in Hebei Provincial Chest Hospital from August 2012 to November 2014.The leak time of the patient and the time of the chest tube were recorded,the pulmonary re-examination was observed by chest X-ray,and the follow-up results were recorded.Results The time of persistent pulmonary air leak of 6 patients was not more than 10 hours after operation,1 patient was not more than 24 hours.Review of X-ray chest showed that good for lung,4-7 d after operation removal of thoracic dosed drainage tube,there was no death and no chest infection in 7 patients and review of CT chest showed no significant residual cavity.After follow-up for 6-24 months 7 patients had satisfactory efficacy,there was no pneumothorax and thoracic infection,no residual cavily.Conclusion Autologous pleura can be used to patch the pulmonary wound in the surgical operation on the patient with chronic tuberculous empyema.

A total of 226 strains of organisms was isolated from the cultures of the subeschar unburnt tissues of the burn patients admitted to this institute in the period from April 1980 to April 1982. Among the organisms, gram-negative bacilli exceeded gram-positive cocci in number. The frequently seen gram-negative bacilli, in the order of frequency, were Pseudomonas, Serratia, Klebsialla, and E. coli. And the frequently seen gram-positive cocci were Staphylococcus aureus, Staphylococcus albus, Streptococcus fecalis, and Streptococcus hemolyticus.The quantitative culture of the biopsy specimen showed its value in our clinical application. In cases of multiple infections, after the identification and precise count of the bacterial colonies on the cultures were done, the percentage of the various organisms could be obtained and the main pathogen was revealed.It was pointed out that ordinary culture media were only favorable for rapid growth of bacteria but the existence of fungi was usually masked. A. modified method of fungus culture, tissue thread culture, was used for the early diagnosis of fungus infection. 38 specimens were studied simultaneously with three methods. The positive rate for fungus was 8% in ordinary cultures, 26% in his-tologic examinations, and 61% in tissue thread cultures.Anaerobic culture was performed for 102 swab specimens from the burn wounds and a positive rate of 14.7% was obtained. In addition, anaerobic blood culture was performed in 10 cases of severe burns with 2 positive cultures. It is suggested that anaerobic infections should not be neglected in burns.

Objective To discuss the value of ischemia modified albumin (IMA) in the early diagnosis of acute coronary syndrome (ACS). Methods The IMA,cTnI, CK-MB and ECG were detected in 103 patients with suspected ACS (45 cases of NICP and 58 cases of ACS) within 5 hours of acute chest pain onset respectively. 30 healthy subjects were served as normal controls. Receiver operating characteristic (ROC) analysis was used to determine the optimal cutoff of this assay for identifying individuals with ACS from non-ischemic individuals (nonischemic chest pain, NICP). Results of IMA,cTnI,CK-MB and ECG were correlated with the final diagnosis and their diagnostic sensitivities for ACS were evaluated. Results The results suggested that acute phase IMA values between those with ACS and NICP were (89.66 ± 25.82) U/ml, (46.79 ± 17.20) U/ml respectively and showed significant difference. Area under the curve (AUC) of the ROC was 0.935. As the Cut-off point was 71.6 U/ml, the sensitivity, specificity, PPV and NPV of IMA were 90.6%, 71.4% , 82.8% and 83.3%, respectively. The simutanious positive rate of IMA for ischemia origin were 29.3% of cTnI,27.6% of CK-MB and 48.3% of ECG(P＜ 0.01). Conclusions Plasma IMA assessment is valuable for early diagnosis of acute coronary ischemia, and will improve the early diagnostic sensitivity of ACS significantly.

Objective To investigate the value of ischemia modified albumin (IMA) detection in preliminary diagnosis of acute myocardial infarction (AMI).Methods The levels and variations of IMA,cTnI and CK-MB in 103 patients with acute chest pain were measured continuously at 0,4,6,12,24 hours after admission respectively.Thirty healthy subjects were observed as normal controls.Results Twenty three patients were diagnosed as AMI in the end,the sensitivity and specificity rates right after admission were 89.3％ and91.3％ for IMA,48.4％ and 92.3％ for CK-MB,30.6％ and 93.7％ for cTnI respectively.The sensitivity values at the 6th hours after admission were 91.3％ for IMA,52.2％ for CTnI and 34.8％ for CK-MB respectively.The specificity was 100.0％ when the IMA was detected in combination with CK-MB or cTnI.The sensitivity of co-detection was significantly higher than that any single detection at sixth hours after admission (x2 =15.99,P ＜ 0.01 ).Conclusion Plasma IMA assessment is helpful for early diagnosis of AMI,and will significantly improve the sensitivity early diagnosis of AMI.The co-detection of IMA and CK-MB or cTnI obviously surpasses any single detection,and has extremely vital clinical significance.

Maize is one of the most important food crops. Rice black-streaked dwarf virus is a maize rough dwarf disease pathogen. The occurrence and transmission of maize rough dwarf disease brings great damage to maize production. The technology of using artificial miRNA to build antiviral plant has been proven effective in a variety of plants. However, such trials in maize have not been reported. We designed primers based on the sequence of maize zea-miR159a precursor and sequence of function protein genes and silencing RBSDV coding genes in RBSDV genome. We constructed amiRNA (artificial miRNA) gene for silencing RBSDV coding gene and gene silencing suppressor. We constructed pCAMBIA3301-121-amiRNA plant expression vector for transforming maize inbred lines Z31 by using agrobacterium mediated method. After molecular analysis of transgenic maize, homozygous lines with high miRNA expression were selected by molecular detection for a subsequent natural infection experiment. We studied the severity of maize rough dwarf disease according to a grading standard (grade 0 to 4). The experiment results showed that the disease resistance of transgenic homozygous maize with the anti-rough dwarf virus amiRNA vector was better than that of wild type. Among the transgenic maize, S6-miR159 transgenic maize had high disease resistance. It is feasible to create new maize variety by the use of artificial miRNA.
Disease Resistance ; genetics ; Gene Silencing ; Genetic Vectors ; MicroRNAs ; genetics ; Plant Diseases ; genetics ; virology ; Plants, Genetically Modified ; genetics ; Reoviridae ; pathogenicity ; Zea mays ; genetics

Objective:To simulate the placement of percutaneous cortical bone trajectory (CBT) screws on reconstructed CT images and three-dimensional lumbar model and to measure the morphometric parameters for guiding the placement of percutaneous CBT screws.Methods:The CT images of 100 adult patients with lumbar spine diseases were studied. The CT images were reconstructed using Mimics software. Taking the projection point on the lamina at the junction of the inner and lower edge of the smallest coronal section of lumbar pedicle as the entry point, the cephalad angle, lateral angle, maximum screw length, maximum screw diameter, distance between trajectory and spinous process were measured. At the same time, the relationship between the trajectory and spinous process was observed by using the reconstructed three-dimensional image.Results:The lateral angle of the trajectory from L 1 to L 5 were 9.3° (8.9°, 9.8°), 9.6° (8.9°, 9.8°), 10.4° (9.5°, 11.3°), 11.81°±1.24° and 13.6° (12.5°, 14.5°), respectively. The cephalad angle from L 1 to L 5 were 26.6° (26.0°, 27.0°), 26.2° (25.7°, 26.5°), 26.9° (26.5°, 27.4°), 25.94°±0.92° and 24.3° (22.7°, 25.4°), respectively. Significant statistic differences were found among all levels in the cephalad angles and lateral angles. The mean diameters of the trajectory from L 1 to L 5 were 5.65±0.49 mm, 6.38±0.60 mm, 6.91±0.67 mm, 7.42±0.76 mm and 8.33 (7.59, 9.01) mm, respectively. Except L 1 and L 5, there were significant differences among all levels in the maximum screw diameters. The mean length of the trajectory from L 1 to L 5 were 36.4 (35.4, 37.0) mm, 36.7 (35.8, 37.3) mm, 37.6 (37.1, 38.1) mm, 37.8 (37.3, 38.1) mm and 36.2 (35.2, 36.9) mm, respectively, and there were also significant differences among all levels. The ration in superior endplate for each segment were 41.08% (34.36%, 45.60%), 37.94% (32.97%, 43.63%), 40.18% (34.56%, 44.49%), 38.61% (34.80%, 46.24%) and 40.9% (35.32%, 46.02%), respectively and statistical differences were significant between L 1 and L 2 and L 2 and L 5. The mean distance between the trajectory and the spinous process from L 1 to L 5 were 7.27±1.23 mm, 7.19 (5.97, 8.28) mm, 7.32 (6.01, 8.28) mm, 7.31±1.36 mm and 7.45 (6.32, 8.23) mm, respectively. In the sagittal CT image, the tip of the trajectory located near the posterior two-fifths of the superior end plate, and the extended line of the trajectory located at the inferior edge of spinous process. In the three-dimensional reconstruction model, no obstruction was found between the simulated screws and the spinous process. Conclusion:Lumbar CBT screw can be implanted percutaneously, and spinous process will not hinder the implantation process. Spinous process and upper endplate can be used as a sign to guide the percutaneous CBT screw implantation. Digital analog screw placement can offer a useful reference for the clinical application of percutaneous cortical bone trajectory screw.