Objective To discuss the diagnosis and surgical treatment of the primary right ventricular tumors.Methods The results of surgical treatment of 7 patientss (5 males,2 females; median age,48 years,range,37 to 68 years) with primary right ventricular tumors hospitalized from Jan,1999 to May,2012 were analyzed.By preoperation echocardiography,cardiac myxoma was diagnosed in 2 cases,and cardiac space-occupying lesion was diagnosed in 5 cases.Median sternotomy were performed in all the 7 cases for biopsy or resection of tumor.when resection of tumor,extracorporeal circulation and cardiac arrest were performed.Results The 7 patients accounted for 4.96％ of patients with cardiac tumors surgically treated in the corresponding period.Complete resection of tumor was performed in 5 cases,and only biopsy in 2 cases.The pathological diagnoses included myxoma in 2 cases,lipoma in 1 case,liomyoma in 1 case,undifferentiated sarcoma in 1 case,and mesenchymal sarcoma in 2 cases.There was no in-hospital death.During a follow-up of 1 ～ 51 months (median,38 months),the 3 cases of sarcoma died,and the other patients were good and showed no recurrence.Conclusion The incidence rate of primary right ventricular malignant tumor is relatively high.Echocardiography is the most important diagnosis method.The prognosis of right ventricular malignant tumor is poor.The results of surgical treatment of right ventricular benign tumor are satisfactory.

Objective To evaluate valvular functionality after transcatheter pulmonary valve replacement in sheep using a novel polymeric prosthetic pulmonary valve.Methods In this study,we designed a novel polymeric trileaflet transcatheter pulmonary valve with a balloon-expandable stent,and the valve leaflet was made of 0.1 mm expanded polytetrafluoroethylene (ePTFE).We chose bovine pericardium valve as control.Pulmonary valve stents were implanted in situ by right ventricular apical approach in 8 healthy sheep(6 for polymeric valve and 2 for bovine pericardium valve) weighing an average of(22.8 ± 2.2) kg.Angiography was performed after implantation to assess immediate valvular function.Color Doppler echocardiography and 64-row computed tomography were used to assess valvular function 4 weeks after implantation.Results Implantation was successful in 8 sheep.Angiography at implantation showed one polymeric valve was located below the ideal position and most of the stent was in the outflow tract of right ventricle.While,all the other prosthetic valves demonstrated orthotopic position and exhibited normal open and close functionality.Echocardiography 4 weeks after implantation showed all the prosthetic valves exhibited normal functionality and no significant insufficiency.The peak-peak transvalvular pressure gradient of the polymeric valves was (18.8 ± 6.0) mmHg,while that of two bovine pericardium valves were 9 mmHg and 20 mmHg.CT 4 weeks after implantation demonstrated orthotopic position of the stents except the above-mentioned one and all the stents had no deformation.Conclusion The success rate of transcatheter pulmonary valve replacement by right ventricular apical approach is satisfactory.The early valvular functionality of the novel ePTFE pulmonary valve after transcatheter pulmonary valve replacement in sheep is good.

BACKGROUND:Our preliminary study found that the monocusp valves made of ultramicropore expanded
polytetrafluoroethylene (ePTFE) revealed no significant thrombus, calcification, or degradation 20 weeks after implanted into the descending aorta and the left pulmonary artery in sheep, which verified the good property of ePTFE. However, the surface of ePTFE in the left pulmonary artery was covered with obvious neointima.
OBJECTIVE: To assess the biocompatibility of phosphorylcholine-coated ePTFE.
METHODS:ePTFE surface was modified by phosphorylcholine derivative. Then the changes of surface shape, tensile stress at yield and elasticity modulus, water contact angle, and protein absorption capacity of ePTFE after surface modification were observed. (1) Hemolytic test: the leaching solution of phosphorylcholine-coated ePTFE, leaching solution of uncoated ePTFE, normal saline, and distiled water were added to the diluted human blood, respectively. (2) Platelet count test: the phosphorylcholine-coated ePTFE, uncoated ePTFE, high density
polyethylene, and Zymosan A were added to the whole blood samples from healthy volunteers, respectively.
(3) Platelet activation test: the phosphorylcholine-coated ePTFE, uncoated ePTFE, γ-Globulins, and Zymosan A
were added to the whole blood samples from healthy volunteers, respectively.
RESULTS AND CONCLUSION: The mean micropore diameter of ePTFE was significantly decreased after
phosphorylcholine coating (P < 0.001). The hydrophilicity and the ability of suppressing protein adsorption were
significantly strengthened after phosphorylcholine coating (P < 0.001). Phosphorylcholine coating did not influence
ePTFE in biomechanical properties and hemolytic test. The platelet count test and platelet activation test demonstrated that phosphorylcholine coating significantly improved anti-thrombus function of ePTFE. So, phosphorylcholine coating can enhance anti-thrombus function, suppress protein adsorption, and improve biocompatibility of ePTFE.

Objective To discuss the clinical value of dynamic monitoring the copies of human cytomegalovirus(HCMV)-DNA in prophylaxis of HCMV pneumonia after renal transplantation.Methods There were 242 cadaveric renal transplantation recipients including 144 males and 98 females,with the average age of 41(from 17 to 71).They were divided into 2 groups(experimental group 127 cases,control group 115 cases).Recipients in experimental group were routinely monitored by blood preparation and urine aliquot FQ-PCR.The therapy was initiated when HCMC-DNA>1×103 copies/ml by blood preparation and/or urine aliquot FQ-PCR with intravenous ganciclovir for 4 weeks.The dosage was calculated according to creatinine clearance rate.FQ-PCR monitoring and Preemptive therapy was not performed in the control group.The pneumonia rate, death rate and survival between the two groups were compared. Results In experimental group, the HCMV pneumonia incidence rate was 6.3 % (8/127), onset time was 46-167 d, median time was 84 d, hospitalization time was 30-57 d,median time was 36 d, death rate was 12.5 % (1/8), breathing machine using rate was 12.5 % (1/8),concurrent other pathogen infection rate was 25 % (2/8), and + year renal graft survival rate was 98.4% (125/127).One was dead with graft function and the other dysfunction was because of acute rejection.In control group, the HCMV pneumonia incidence rate was 14.8%(17/115), onset time was 34-138 d,median time was 51 d, hospitalization time was 21-67 d,median time was 40 d,breathing machine using rate was 29.4% (5/17),concurrent other pathogen infection rate was 41.2%(7/17), death rate was 23.5% (4/17), and 1 year renal graft survival rate was 93.0% (107/115).Three was dead with graft function and the other one was dead of DGF.The other 4 cases of renal dysfunction were because of acute rejection.Significant difference existed between the 2 groups (P<0.05) except for hospitalization time (P> 0.05). Conclusion The preemptive therapy of CMV pneumonia after renal transplantation by dynamic monitoring the copies of HCMV-DNA in recipients could have a good effect, and the 1 year renal graft survival rate could be higher.

Objective: To explore the effect of exercise preconditioning (EP) on pathological cardiac hypertrophy and heart failure (HF) in pressure over-loaded experimental rats.
Methods:A total of 60 SD rats at the age of 6 weeks were randomly divided into 3 groups, n=20 in each group. Sham-operation group, Transverse aortic constriction (TAC) group and EP + TAC group. The cardiac function and structure were evaluated by echocardiography, patholgical changes and HF biomarkers were examined for EP effect at 4 and 8 weeks after TAC.
Results:Compared with Sham-operation group, the cardiac function and structure had obvious changes in the other 2 groups. Compared with TAC group, the ejection fraction in EP+ TAC group increased 15%, the heart weight index and left ventricular weight index decrease 15.7%and 20%respectively at 8 weeks after TAC, all P<0.05. Compared with Sham-operation group, the mRNA and protein expressions of ANP and BNP increased in TAC group at 4 and 8 weeks after TAC, increased in EP+TAC group at 8 week after TAC. Compared with TAC group, the mRNA expressions of ANP and BNP in EP+TAC group decreased 47%and 62%at 4 weeks after TAC, decreased 44%and 28.1%at 8 weeks after TAC, all P<0.05;the protein expression of ANP and BNP in EP+TAC group decreased 22.3%and 48%at 4 weeks after TAC, decreased 21.5%and 38.3%at 8 weeks after TAC, all P<0.01.
Conclusion: EP may improve cardiac pathological hypertrophy in pressure over-loaded rats at the early stage, and delay the heart failure process.

Objective To investigate the utility of virtual endoscopy ultrasound Fly-Thru in the diagnosis of obstructive bile duct diseases.Methods One-hundred patients with obstructed bile duct diseases underwent Fly-Thru examination.All Fly-Thru images were reviewed by two radiologists with different experience.The capabilities of Fly-Thru for bile duct obstructive degree evaluation and distinguishing malignant lesion from benign one were assessed respectively.Results The accuracy and sensitivity of Fly-Thru image in obstruction degree evaluation were 70.59％ and 89.2％ (95％CI 74.6％-96.9％).The diagnosis accuracy of 2DUS for lesion characteristics increased from 80％ to 84％,accompany with Fly-Thru images,especially for lesions in common bile duct from 77.2％ to 86.0％ (x2 =14.399,P =0.001).Conclusions The virtual endoscopy ultrasound Fly-Thru is only partly capable to display the obstructed degree of some bile ducts,but it can improve the diagnostic accuracy of common bile duct diseases.

Objective To observe the feasibility of 125I intra-operative implantation plus palliative resection of gastric carcinoma for treatment of advanced gastric cancer infiltrating pancreas. Methods 125 I was implanted intraoperatively into the residual pancreatic cancer tissues after gastric carcinoma was palliatively removed. Results From Feb. 2005 to Jun. 2009, 15 cases (9 male, 6 female) advanced gastric cancer patients were treated with 125 I intra-operative implantation. The patients' ages ranged from 41 to 78 years, with the median age of 64 years old. There were 10 cases of gastric cancer infiltrating the neck or body of pancreas and 5 cases infiltrating pancreatic head. No severe post-operative complications were recorded. The follow-up showed that there were 5 cases of CR (33.3%), 9 cases of PR (60%), 1 case of NC (6.7%) and no PD patients were found. Conclusion 125I intra-operative implantation plus palliative gastric resection is feasible and effective for patients of advanced gastric cancer infiltrating the pancreas.

OBJECTIVETo observe the effect of exercise preconditioning (EP) on pressure overload-induced pathological cardiac hypertrophy and explore related mechanisms.

METHODSTen-week-old male Sprague-Dawley rats (n = 80) were randomly divided into four groups via random number table method: sham, TAC, EP + sham and EP + TAC. Two EP groups were subjected to 4 weeks of treadmill training, and followed by sham and TAC operations. Eight weeks after the surgery, mean arterial pressure (MAP), cardiac morphology, mRNA expressions of the B-type natriuretic peptide (BNP) and heat shock protein (HSP) 70 and protein expression of the BNP, heat shock transcription factor 1 (HSF1), HSP70, nuclear factor κB (NF-κB) p65, and interleukin-2 (IL-2) were examined.

RESULTS(1) Pathological cardiac hypertrophy index: eight weeks after TAC, MAP, heart size, HW/BW, cross-sectional area of the cardiomyocytes (CSA) and mRNA and protein expressions of BNP in the LV were all significantly higher in the TAC and EP + TAC groups than respective sham groups (all P < 0.05). HW/BW, CSA, and mRNA and protein expressions of BNP in the LV were significantly lower in EP + TAC group than in TAC group (all P < 0.05). (2) mRNA and protein expressions of HSF1 and HSP70 and nuclear HSF1 levels were significantly downregulated post TAC, however, EP treatment significantly increased the expression of HSF1 and nuclear HSF1 levels in TAC rats (all P < 0.05). (3) mRNA and protein expressions of NF-κB p65 and IL-2 were significantly increased in the TAC and EP + TAC groups compared with the respective sham groups (all P < 0.05), which were significantly downregulated in EP + TAC group compared to TAC group (all P < 0.05).

CONCLUSIONSEP could effectively reduce the cardiac hypertrophic responses induced by TAC possibly through upregulating the expressions of HSF1 and HSP70 and inhibiting the expression of NF-κB p65 and its nuclear translocation.

Animals ; Cardiomegaly ; DNA-Binding Proteins ; Down-Regulation ; HSP70 Heat-Shock Proteins ; Heat Shock Transcription Factors ; Interleukin-2 ; Male ; Myocytes, Cardiac ; Natriuretic Peptide, Brain ; Physical Conditioning, Animal ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Transcription Factor RelA ; Transcription Factors

By detection and analysis of neuro-information from amputee in experiments, a research on the correlations of three main nerves (median nerve, radial nerve and ulnar nerve), on the patterns for discharging information, and on the mechanics about how neuro-information dominates movements was performed. These researches would contribute to the development of neuroprosthesis.
Adult ; Amputation ; Amputees ; Arm ; Artificial Limbs ; Humans ; Male ; Median Nerve ; physiology ; Microelectrodes ; Movement ; physiology ; Radial Nerve ; physiology ; Ulnar Nerve ; physiology

Objective:To explore the relationship between the diameter of drainage used in closed thoracic drainage (CTD) and the prognosis of patients with thoracic trauma.Methods:This study was a retrospective cohort study, a total of 146 patients who were admitted to the 971st Navy Hospital due to thoracic trauma from April 2017 to June 2021 and received closed thoracic drainage were selected as the research subjects. According to the prognosis, they were divided into a good group ( n=96) and a poor group ( n=50), and the clinical efficacy, general data and postoperative complications of the two groups were compared and analyzed. Multivariate Logistic regression was used to analyze the risk factors for poor prognosis, and a nomogram prediction model was established, and the model was evaluated. The relationship between the size of drainage diameter and the prognosis of patients with thoracic trauma was analyzed by Pearson correlation. The normally distributed measurement data was expressed by the ( ± s), and the independent samples t test was used for comparison between groups; The chi-square test was used for comparison of count data between groups. Results:The clinical efficacy of CTD was good, with a total effective probability of 87.67%; and 3 weeks after surgery, the patient′s prognosis was good, with a good prognosis probability of 65.75%. Logistic analysis showed that age 60 years old ( OR=1.501, 95% CI: 1.105-2.177), excipient replacement time of 2-3 d ( OR=2.543, 95% CI: 1.729-3.168), drainage bottle higher than thoracic cavity ( OR=1.692, 95% CI: 1.314-2.482), long wound healing time ( OR=1.971, 95% CI: 1.479-2.720), frequent cough ( OR=2.259, 95% CI: 1.564-2.924), and drainage tube diameter 16 F ( OR=3.087, 95% CI: 2.074-3.793) were independent risk factors for poor prognosis ( P<0.05). The size of drainage diameter was positively correlated with hospitalization and wound healing time, pain VAS score ( P<0.05), and negatively correlated with Barthel Index ( P<0.05). Conclusion:Drainage tube diameter 16 F is one of the independent risk factors for poor prognosis of patients. The smaller the drainage diameter, the shorter the postoperative hospital stay, faster wound healing, lighter pain and stronger ability of life and activity.