Objective To explore the efficacy,indication and the treatment of complication of concomitant thoracic aortic replacement and endoluminal stent grafting (hybrid technique) for DeBakey type Ⅰ aortic dissection. Methods From September 2005 to June 2009,12 patients with acute DeBakey type Ⅰ aortic dissection were diagnosed by contrast-enhanced CT or MRI scan, and underwent hybrid technique.Computed tomography angiography (CTA) was performed in each patient at 2,6 months after operation to check up the post-operative course,such as ascending aortic and vascular prosthesis of aortic arch and decending aorta. The time of the post-operational follow-up was 6 -36 months. Results All patients successfully recovered from surgery procedure,no serious complication. The time of cardiopulmonary bypass was 196 -298 (264.0 ± 36.6) min,arrest time of ascending aortic was 89 -276 (213.6 ±43.8) min. All patients were discharged from hospital. Contrast-enhanced CT or MRI indicated the vascular prosthesis to been unobstructed,no endo-stent dislocation and no organ ischemia, the false lumen and thrombosis disappeared in 10 patients,but false lumen and leakage happened in 2 patients at 2 months after operation.The false lumen disappeared at 6 months after operation. Conclusions Hybrid technique for DeBakey type Ⅰ aortic dissection is satisfactory in short term effect with less invasiveness and definite safety. However,further studies are needed to evaluate its long-term outcomes.

Objective To investigate the spatio-temporal expression of connexin 43(Cx43) in the cultured ventricular myocardial cells of neonatal rats. Methods The techniques of Immunocytochemistry(ICC) and immuno-electron microscopy were used to detect the Cx43 expression in the cultured rat ventricular myocardial cells on the(2nd),(4th),(8th),(10th),(12th),(16th),(20th,)(26th) and(30th) days. Results Cx43 expression was detected in the cultured ventricular myocardial cells on the 2(nd) day,and the Cx43 granules were located largely in the cellular cytoplasm and membrane.The punctiform granule of the cellular cytoplasm decreased and the expression of Cx43 was located mainly in cellular membrane junction on the 4(th) day.The expression of Cx43 increased in cellular membrane junction on the 10(th) day,and the morphology of Cx43 expression was chain-and strip-like.There were not obvious changes in the following days.The expression of Cx43 on the 30(th) day was derangement.Conclusion The spatio-temporal expression of Cx43 in the cultured ventricular myocardial cells of neonatal rats changed with the cultural time in terms of location and quantity.It was in accordance with the growth and development of the cultured ventricular myocardial cells.

ObjectiveTo investigate the role of T-type calcium channel in the spinal neurotoxicity of intrathecal (IT) lidocaine in rats.MethodsForty-eight adult male SD rats in which IT catheter was successfully implanted,weighing 230-270 g,were randomly divided into 4 groups ( n =12 each):dimethyl sulfoxide (DMSO)group (group D),lidocaine group (group L),mibefradil + lidocaine group (group M),normal saline + lidocaine group (group N).Another 12 rats served as control group (group C).DMSO and 10％ lidocaine 20μl were injected intrathecally in groups D and L respectively.After mibefradil 200 μg/10μl and normal saline 10 μl were injected intrathecally in groups M and N respectively,10％ lidocaine 20 μl was injected intrathecally in the two groups.The mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured before IT injection and at 2,4,8 and 12 h and 1,2,3,4 and 5 d after IT injection (T0-9).Four rats were sacrificed at T6 in each group and their lumbar enlargements were removed for microscopic examination.ResultsCompared with group C,no significant change in MWT and TWL was found at each time point in group D,MWT was significantly increased at T1-8 and TWL was significantly prolonged at T1-7 in groups L and N,and MWT was significantly increased at T1-6 and TWL was significantly prolonged at T1-6 in group M ( P ＜ 0.05 ).Compared with groups L and N,MWT was significantly decreased at T1-4 and TWL was significantly shortened at T1-4 in group M ( P ＜ 0.05).Pathological injury was significantly reduced in group M as compared with groups L and N.ConclusionT-type calcium channel is involved in the spinal neurotoxicity of IT lidocaine in rats.

Objective To investigate the biocompatibility between the atelocollagen scaffold and 3D-cultured myocardial cells,and to find out the condition and an optimal biomaterial scaffold that can be applied to 3D-culture myocardial tissue. Methods The primary cultured myocardial cells were purified and then inoculated into the atelocollagen scaffold.The cells in the atelocollagen scaffold were observed by light microscope,scanning electron microscope(SEM) and transmission electron microscope(TEM) at different times(8d,16d,20d). Results On the first day,cardiac cells pulsating together with the atelocollagen scaffold could be detected under the microscope,which were pulsating complex.A plenty of cells in the atelocollagen mesh were observed under the light microscope,and the cells coalesced with the scaffold.The cells were compacted to the scaffold and coalesced with it at three stages under TEM.Those cells were sticked to the atelocollagen scaffold and expanded sufficiently under SEM.On the atelocollagen scaffold surface,these cells coalesced with lamellar.Conclusion The biocompatibility of the atelocollagen scaffold is better for cultured cardiac myocyte.It can be used as a natural material for 3D-cultured cells,and is suitable for 3D-cultured cardiac cells and cardiac tissues.

Objective To investigate the role of T-type calcium channel in lidocaine-induced neuronal cytotoxicity . Methods SH-SYSY cell line was a gift from cell biology laboratory of our medical university. The cells were cultured in DMEM liquid culture medium at 37℃ in incubator filled with 5% CO2 , and randomly divided into 4 groups ( n = 66 each) : control group (group C)and M, L and ML groups were exposed to 5 μmol/L mibefradil (a T-type calcium channel blocker), 10 mmol/L lidocaine and 5 μmoL/L mibefradil + 10 mmol/L lidocaine for 24 h. Cell morphology was examined by electronic microscopy at 24 h of drug exposure. Cell viability (by MTT) and neuronal apoptosis (by flow cytometry) were detected immediately before and at 1, 6, 12 and 24 h of exposure to mibefradil or/and lidocaine.Results In C and M groups, the cells demonstrated dendritic protrusions, enlarged nerve processes and dense lattice. After being exposed to lidocaine for 24 h, the dendritic protrusions disappeared,the cells decreased in size, shrinked and became round; the cell viability was significantly decreased while the neuronal apoptosis increased. The lidocaine-induced changes were significantly attenuated by co-incubation with mibefradil. ConclusionT-type calcium channel is involved in lidocaine-induced neuronal cytotoxicity.

ObjectiveTo establish a rat model of nerve damage induced by intrathecal(IT) lidocaine.MethodsFifty-five adult male SD rats weighing 200-220 g were randomly divided into 5 groups (n =11 each):group normal control (group C); group dimethyl sulfoxide (DMSO)-the solvent(group D) and groups IT 5％,10％,15％ lidocaine (groups L5.10.15 ).IT catheter was successfully implanted without complication in groups D,L5,L1o,L15.DMSO,5％,10％ and 15％ lidocaine 20 μl were injected IT in groups D,L5,L10,L15 respectively.Motor dysfunction of hindlimb was assessed and scored (0 =normal,2 =complete block) and paw withdrawal threshold to mechanical stimulation (von Frey filaments) (MWT) and paw withdrawal latency to thermal nociceptive stimulus (TWL) were measured before (baseline) and at 1,2,3,4,5,7 d after IT administration in 8 animals in each group.Three animals in each group were sacrificed at 1 d after IT administration.The lumbar segment (L4-5) was removed for microscopic examination.ResultsThere was no significant difference in motor dysfunction score,MWT and TWL among groups C,D and L5.MWT was significantly increased and TWL prolonged at 1 and 2 d after IT administration in group L10,while in group L15 motor dysfunction score was significantly increased at 1,2 d after IT administration and MWT was significantly increased and TWL prolonged at 1,2,3 d after IT administration.There was significant histologic damage to spinal cord in groups L10 and L15.Conclusion Nerve damage can be induced by IT 10％ lidocaine.

Objective To investigate the cosmetic outcome of treatments for mentalis scars with expanded skin flaps.Methods From the experiences of past 26 cases in our department,we summarised the technique for treating the mentalis scars with expanded skin flaps.For simple mentalis scars or localized inferior facial scars,the mentalis,bottom jaw or facial skin were expanded and the expander kept superior to the neck-jaw angle.Otherwise the expander would only fill the angle and the expanding efficiency was reduced.For severe mentalis,neck or facial scars without extra normal treating skin,expanded deltopectoral flaps were chosen to cover the wound after cicatrectomy with pedicles which were cut 3 weeks later.Results All the local ordistant expanded flaps survived successfully in the 26 cases with optimistic outcomes.Conclusions Application of local or distant expanded flaps is a useful technique for mentalis scars treatment.

Objective To evaluate the role of C-Jun N-terminal kinase (JNK) signal transduction pathway in spinal neurotoxicity induced by lidocaine in rats.Methods Seventy-two adult male Sprague-Dawley rats,weighing 220-260 g,were randomly divided into 6 groups (n =12 each):control group (group Ⅰ),sham operation group (group Ⅱ),JNK inhibitor group (group Ⅲ),dimethyl sulfoxide (DMSO) group (group Ⅳ),lidocaine group (group Ⅴ),and JNK inhibitor and lidocaine group (group Ⅵ).Group Ⅰ received no treatment.Intrathecal catheter was placed in the subarachnoid space in group Ⅱ.SP600125 25 μg and DMSO 20 μl were injected intrathecally in Ⅲ and Ⅳ groups,respectively.In group Ⅴ,10％ lidocaine 20 μl was intrathecally injected.SP600125 25 μg was injected intrathecally and 30 min later 10％ lidocaine 20 μl was injected intrathecally in group Ⅵ.Paw withdrawal threshold to yon Frey filament stimulation (PWT) and paw withdrawal latency to nociceptive thermal stimulation (PWL) were measured before intrathecal catheter was implanted (T0),before intrathecal administration (T1) and at 4,8 and 12 h and on 1,2,3,4,5 and 6 days after intrathecal administration (T2-10).At 24 h after intrathecal administration,4 rats were randomly chosen from each group and sacrificed.Their lumbar enlargements were removed for determination of phosphorylated JNK (p-JNK) expression (using Western blot) and neuronal apoptosis (by TUNEL).The apoptotic index was calculated.Results Compared with group Ⅰ,no significant difference was found in MWT and TWL in Ⅱ,Ⅲ groups and expression of p-JNK in Ⅱ and Ⅳ groups (P ＞ 0.05),MWT at T2-4,6-8 and TWL at T2-4,7 in group Ⅴ and MWT at T2-6 and TWL at T2-5 in group Ⅵ were significantly increased,the expression of p-JNK was down-regulated and the apoptotic index was decreased in group Ⅲ (P ＜ 0.05),and the expression of p-JNK was up-regulated and the apoptotic index was increased in Ⅴ and Ⅵ groups (P ＜ 0.05).Compared with group Ⅴ,MWT and TWL were significantly decreased,the expression of pJNK was down-regulated and the apoptotic index was decreased in group Ⅵ (P ＜ 0.05).Conclusion Activation of JNK signal transduction pathway is involved in spinal neurotoxicity induced by lidocaine in rats possibly through promoting neuronal apoptosis in the spinal cord.

Objective To investigate the feasibility of transplantation of mesenchymal stem cell (aisc) into expanion skin. Methods MSCs were isolated from porker's bone marrow and cultured in vitro. Pigs were randomly divided into four groups: Group A was injected with MSCs on the local expansion; Group B was injected with MSCs from ear vein; Group C was planted expander only; Group D was the contronl group. Each side of pig's spinal column was implanted with three expander in groups A, B and C. The same volume of NS was injected at the fixed time, the marked area measured after 7, 14, 28 days of expansion, the difference of those area was compared between groups. The differentiation of BM-MSC was detected by immunofluorescence. Results Flow-cytometric analysis showed that these BMSCs expressed CD90 and CD29 highly but did not express CD34 or CD45. The expansion area (cm2) of groups A, B, C and D was 34.05±0. 92, 31.83±l. 07,30. 10±0.79, and 18. 27±0.25, respectively (P＜0. 01). Immunofluorescence showed that the positive expression rate of CD31, PCNA in groups A and B was higher than that in groups C and D, in which the expression was the highest in group A. Conclusions Allogeneic transplantation of BM-MSC can promote skin expansion and the effect of local transplantation group is most significant.