Based on the first hand cardiothoracic surgical training experiences in Australia, the author introduced the Australian surgical training system's objective, structure, outline and specific training methods as well as its contents in detail. Its overall characters can be summarized as high standard, strict requirement and equal stress on both theory and practice. Hopefully, this introduction and reflection may shed some light on the improvement and evolvement of the resident training system in China.

Objective 22q11 microdeletion is featured with hemotological dysfunction,among others:hypocalcemia,thrombocytopenia and megathrombocyte.This study was trying to work out the platelet characteristics of 22q1 1 microdeletion patients and its potential clinical application.Methods A total of 80 cases who had undergone open-heart surgery were selected and confirmed with fluorescence in situ hybridization (FISH) to have 22q1 1 microdeletion among 40 cases while the others were negative.The relevant data in full blood routine of all the 80 cases in hospital information system (HIS) then were collected and analyzed with suitable statistical methods.Results The mean platelet volume in microdeletion group was statistically higher than that in the control group [(11.20 ± 1.94)fL vs (8.95 ± 1.58) fL,P ＜0.01].The area under the receiver operating characteristic (ROC) curve was 0.82,meaning significant predictive values.The corresponding sensitivity and specificity for mean platelet volume (MPV) =10 fL were 70.0 ％ and 80.0 ％,respectively.Conclusions MPV in congenital heart defect patients with 22q11 is significantly higher than those without 22q11.It is an effective method for preliminary screening 22q11.Being obtained from full blood routine data,it is economic and quick.MPV =10 fL can be used as a cutoff for guidance for irradiated blood transfusion postoperatively.

Objective To study the feasibility and safety of limb remote ischemic preconditioning (RIPC) in infants and explore the protective effect on myecardium ischemia reperfusion injury for infants undergoing cardiac operation under cardiopulmonary bypass. Methods 60 infants weight less than 7 kilograms with ventricular septal defect were enrolled into the study. 30 of them (RIPC group) were ischemic preconditioned two times (24 hours and 1 hour preoperatively) by three cycles of iscbemia (5 minutes for each) and reperfusion on the left upper arm using a blood pressure cuff. Serum lactate dehydrogenase (LDH), creatine kinase (CK) and its isoenzyme (CK-MB), and tro-ponin I (TnI) ; malondialdehyde (MDA) and superoxide dismutase (SOD) was preoperatively detected. The expression of heat shock pro-tein 70 (HSP 70) in cardiomyocytes was determined by western blot analysis. The surgical outcome including limb movement and sensory function was also recorded. Results No limb disability or sensory disturbance or no other surgical complications was found in all infants. LDH, CK, TnI at the beginning of operation in RIPC group was higher than those in control group. After operation, leakage of heart enzymes were attenuated in RIPC group, and the serum concentration of enzymes were lower than those in the control group. The RIPC group had low coronary sinus venous concentration of MDA but high SOD. The expression of HSP70 was upregulated in cardiomyocytes of RIPC group. Conclusion The limb RIPC can be done easily and safety in infants, and BIPC can reduce the leakage of myocardial enzymes and upregu-late the expression of HSP, which possess protective effect on myocardial IRI.

The prevalence of human papilloma virus (HPV)-16 in patients with cervical cancer, the physical status of HPV-16 in patients with cervical lesions, and the role of HPV-16 integration in cervical carcinogenesis were investigated. HPV genotyping was performed by using PCR approach with the primer GP5+/GP6+ and type-specific primer on biopsy specimens taken operatively from 198 women. Multiple PCR was done to detect physical status of HPV-16 in a series of cervical liquid-based cytology samples and biopsy specimens obtained from different cervical lesions with HPV-16 infection, including 112 specimens with cervical cancer, 151 specimens with CIN I, 246 specimens with CIN and 120 specimens with CINIII. The results showed that there were 112 cervical cancer samples (56.57% of total cervical cancer patients) with HPV-16 infection. The frequency of HPV-16 pure integration was 65.18% (73/112), 56.57% (47/120), 23.58% (58/246) and 7.95% (12/151) in cervical cancer, CINIII, CINII and CINI patients respectively. In situ hybridization was performed on some paraffin-embedded sections of CINII, CINIII and cervical cancer to verify the physical status of HPV-16 infection. Significant difference was observed between cervical cancer and CIN I, CINII, CINIII in the frequency of HPV-16 integration (P<0.01). It is suggested that HPV-16 is the most prevalent type and is associated with cervical cancer. In the case of HPV-16 infection there are close associations between the severity of cervical lesions and the frequency of HPV-16 integration. The application of testing HPV genotyping and physical status based on detection of HC-II HPV DNA would be in favor of predicting the prognosis of cervical precancerosis and enhancing the screening accuracy of cervical cancer.

The prevalence of human papilloma virus (HPV)-16 in patients with cervical cancer,the physical status of HPV-16 in patients with cervical lesions,and the role of HPV-16 integration in cervical carcinogenesis were investigated.HPV genotyping was performed by using PCR approach with the primer GP5+/GP6+ and type-specific primer on biopsy specimens taken operatively from 198 women.Multiple PCR was done to detect physical status of HPV-1 6 in a series of cervical liquid-based cytology samples and biopsy specimens obtained from different cervical lesions with HPV-16 infection,including 112 specimens with cervical cancer,151 specimens with CIN Ⅰ,246 specimens with CIN Ⅱ and 120 specimens with CINⅢ.The results showed that there were 112 cervical cancer samples (56.57％ of total cervical cancer patients) with HPV-16 infection.The frequency of HPV-16 pure integration was 65.18％ (73/112),56.57％ (47/120),23.58％ (58/246) and 7.95％ (12/151) in cervical cancer,CINⅢ,CIN Ⅱ and CIN Ⅰ patients respectively.In situ hybridization was performed on some paraffin-embedded sections of CIN Ⅱ,CINⅢ and cervical cancer to verify the physical status of HPV-16 infection.Significant difference was observed between cervical cancer and CIN Ⅰ,CIN Ⅱ,CINⅢ in the frequency of HPV-16 integration (P＜0.01).It is suggested that HPV-16 is the most prevalent type and is associated with cervical cancer.In the case of HPV-16 infection there are close associations between the severity of cervical lesions and the frequency of HPV-16 integration.The application of testing HPV genotyping and physical status based on detection ofHC- Ⅱ HPV DNA would be in favor of predicting the prognosis of cervical precancerosis and enhancing the screening accuracy of cervical cancer.

Objective To evaluate the efficacy and safety of transurethral resection of Prostate(TURP)combined with endocrine therapy in patients with advanced prostate cancer.Methods A retrospective analysis was conducted on 87 cases of late-stage prostate cancer with dysuria admitted between January 2014 and December 2017.We divided them into 2 groups.TURP group(n = 48)received transurethral resection of prostate,followed by regular endocrine therapy.The control group(n = 39)was only given regular endocrine therapy.Comparative analysis of indicators such as prostate-specific antigen before and after treatment,maximum urinary flow rate,residual urine volume,International Prostate Symptom Score(IPSS),and 5-year survival rate was performed between the two groups.Results Three months after TURP surgery,the symptoms of urinary difficulty significantly improved,and various indicators showed significant improvement compared to before the surgery.PSA levels also notably decreased compared to before the surgery.After 3 months of treatment,the TURP group showed significant improvements in IPSS,Qmax,RV,and PSA indicators compared to the control group(P<0.05).Both groups of patients experienced a gradual decrease in PSA levels after receiving standardized treatment.In the first 12 months of treatment,the PSA levels in the TURP group decreased more significantly compared to the control group,but after 12 months of treatment,the comparison difference was not statistically significant in the PSA levels between the two groups(P = 0.056).A 5-year follow-up comparison of the two groups of patients revealed that there was no statistically significant difference in survival(P = 0.734).Conclusion Transurethral resection of Prostate(TURP)combined with regular endocrine therapy can effectively improve the dysuria in prostate cancer patients,improve the quality of life of patients,and will not affect the five-year survival rate.TURP is a safe and effective treatment for advanced prostate cancer.

OBJECTIVE: To evaluate the safety of surgical repair for neonatal aortic coarctation combined with ventricular septal defect.
 METHODS: Twenty-three aortic coarctation neonates received surgical treatment and their clinical data between April, 2013 and May, 2015 were analyzed retrospectively. All patients underwent coarctation repair + ventricular septal defect repair and mild hyperthermia cardiopulmonary bypass under the condition of general anesthesia. All patients were subjected to delayed sternal closure.
 RESULTS: One patient died at early post-operation, and no one died during 2-27 months' follow-up. Operation time, cardiopulmonary bypass time, aortic cross-clamp time, ICU stay time, mechanical ventilation time, delayed sternal closure time, and post-operative hospital stay time were (192.7±43.4) min, (132.4±26.4) min, (65.3±18.4) min, (185.3±56.4) h, (42.4±24.5) h, (36.3±18.6) h, and (15.3±4.6) d, respectively. Post-operative complications presented in 12 patients, including post-operative hemorrhage in 6 patients, acute renal insufficiency in 4 patients, wound infection in 1 patient, and post-operative coarctation of the aorta in 1 patient. 
 CONCLUSION One-stage complete repair for severe aortic coarctation combined with ventricular septal defect in neonates is safe, and the outcomes are satisfied. Fully free of the aortic arch and individual aorta reconstruction are the keies to successful operation.
Aorta ; Aortic Coarctation ; Heart Septal Defects, Ventricular ; Humans ; Infant, Newborn ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Safety