Humans ; Lung Neoplasms ; blood supply ; pathology ; Lymphatic Vessels ; pathology ; Neovascularization, Pathologic ; metabolism ; Vascular Endothelial Growth Factors ; chemistry ; metabolism ; physiology

Objective To analyze the medium and long-term results of tricuspid valve replacement (TVR)and summarize the operative experience for tricuspid valve disease.Methods Clinical data of 27 patients with severe tricuspid valve disease from September 2005 to May 2010 were retrospectively reviewed.Biological valve prosthesis was replaced in 23 patients,while mechanical valve prosthesis was replaced in 4 patients.Accompanying procedures included mitral valve replacement in 8 cases,mitral valve replacement and aortic valve replacement in 4 cases,and repair of atrial septal defect in 4 cases.Results The operative mortality was 11.1％(3/27),among these patients,2 cases died of serious low cardiac output syndrome,1case died of muhiorgan failure on the 7th day after operation,1 case who underwent reoperation for hemorrhage postoperative was improved after treatment.During follow-up,1 patient died of biological valve prosthesis dysfuncion 3 years after operation,1 patient died of cerebral embolism 19 months after operation.Six cases were in New York Heart Association(NYHA)class Ⅰ,and 14 cases in NYHA class Ⅱ during the period of follow-up.Conclusions Because operative and follow-up mortality is high,TVR is the last selection for the treatment of tricuspid valve disease.Appropriate operative technique and perioperative therapy are the key for clinical success.For those older than 50 years,follow-up inconvenience and reproductive-age female patients,biological valve prosthesis should be recommended as a preferential choice.

Objectives To investigate the mutational characteristics of MSX1 and PAX9 genes in a family affected by non-syndromic oligodonti so as to study the pathogenesis of oligodontia from a molecular prospective. Methods A family with oligodontia, but of different descent and unrelated healthy controls were enrolled in our study. Genomic DNA was isolated from the blood samples. Mutation analyses were performed by amplifying MSX1 and PAX9 exons and sequencing the products. Results DNA sequencing revealed a novel missense mutation c.348C>T in a highly conserved homeobox sequence of MSX1 and a known polymorphisms c. 469+35- c.469+45del in exon 1 and in intron in the two patients and in two unrelated healthy controls. But we did not detect any mutation in PAX9. Conclusion Our finding suggests the samesense mutation (c.348C>T) and the polymorphisms (c.469+35- c.469+45del) may be responsible for oligodontia phenotype in this Chinese family.

Background and purpose:Both nature killer cells(NK)and cytoxic T lymphocytes in the body tissues of human are the dominant components of cellular immunity,This study was done to explore the degree of infiltration of NK/T in lung squamous cell carcinoma and its relation to patient survival and prognosis.Methods: CCD8 as the markers cytoxic T lymphocyte(CTL)and CD56 as the markers natural killer(NK)were stained immunohistochemically to detect the distribution and infiltration in the lung squamous cell carcinoma specimens. Results:In 39 of 68 lung neoplasm,whose CTL infiltration was zero or mild,the five-year survival rate was 18%, while in 29 with marked CTL infiltration,the five-year survival rate was 42%.In 46 of 68 lung neoplasm,whose NK infiltration was zero or mild,the five-year survival rate was 14%,while in 22 with marked NK infiltration,the five-year survival rate was 45%.In 48 of 68 lung neoplasm,both the NK and T cells were zero or mild,the five-year survival rate was 33%,while in 20 with marked NK and T cell infiltration,the five-year survival rate was 54%.The five-year survival difference among the patients with NK,T infiltration either marked or zero/mild infiltration were significant(x~2=18.62, P=0.00).Conclusions:The degree of NK and T infiltration is positively correlated with the prognosis and survival time of lung squamous cell carcinoma patients.

Objective To exam the expression and the distribution difference between melatonin membrane receptor subtype Mel 1a and Mel 1b in the central nervous system of rats. Methods In situ hybridization technique was used. Results (1)The Mel 1a mRNA positive cells were mainly detected in the hippocampus,cerebral cortex,supraoptic nucleus,paraventricular nucleus,suprachiasmatic nucleus,inferior olivary nucleus,cortex and fastigial nucleus of cerebellar,ventral horn of the spinal cord,facial nerve nucleus,gigantocellular reticular nucleus,striatum cortex and trigeminal nerve nucleus,etc.(2)The Mel 1b mRNA positive cells were mainly observed in the cerebellar cortex,fastigial nucleus,global nucleus,emboliform nucleus of the medullaris cerebelli,hippocampus,cerebral cortex,ventral horn of the spinal cord,supraoptic nucleus and suprachiasmatic nucleus.Conclusion\ Mel 1a mRNA positive neurons were abundant and distributed widely in the CNS,while Mel 1b mRNA\|positive neurons distributed comparatively localized.However,the hippocampus and the cortex were two regions which were rich in both Mel 1a and Mel 1b mRNA positive neurons.\;[

Objective To observe the clinical effects of intensive insulin therapy on postoperative infection, inflammatory response and prognosis in the non-diabetic patients of different ages undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Methods 60 cases of non-diabetic patients (>60) undergoing coronary artery bypass grafting with cardiopulmonary bypass between June 2005～June 2010 were selected and analyzed retrospectively. 60 patients were divided into 2 groups, the previous 24 cases were included in a routine treatment group and later 36 cases were included in the intensive therapy group. The blood sugar of intensive therapy group was strictly controlled starting from the anesthesia. The routine treatment group was controlled starting from backing to ICU according to blood glucose results. Patients were assigned to the routine therapy group with the blood glucose maintained at 10.0～11.1 mmol/L and the intensive therapy group received tight glycemic control with the target blood glucose maintained at 4.4～6.1 mmol/L. Postoperative infection, mechanical ventilation time, hospital stay and mortality indicators were compared between the 2 groups. Results There were no significant difference (P＞0.05) in gender, body weight, disease diagnosis and combined surgical methods and surgical materials such as cardiopulmonary bypass time between the 2 groups. Neutrophil count［(12.6±2.8)×109/L vs (18.8±3.1)×109/L］, blood infections, respiratory tract infection(6/36 vs 10/24) and wound infectionrates(2/36 vs 6/24) and other indicators of intensive of insulin therapy group were lower than the regular therapy group (P＜0.05). The postoperative hospital stay of intensive therapy group［(12.2±3.7)d vs (15.6±5.4)d)］ was statistically significant shorter compared with the conventional treatment group (P＜0.05). There was no significant difference in postoperative mortality between the 2 groups (P＞0.05). Conclusions Intensive insulin therapy may significantly reduce postoperative infection rate in the old age patients, thus leading to an improved prognosis in the non-diabetic patients undergoing coronary artery bypass grafting with cardiopulmonary bypass.

ObjectiveTo explore the surgical treatment of congenital heart disease combined with severe pulmonary hypertension.MethodsThirty-two patients of congenital heart disease combined with severe pulmonary hypertension were included in the study.The saturation of arterial oxygen ranged from 0.84 to 0.94 and echocardiography showed left to right slow velocity shunt in 20 eases,double direction shunt in 10 cases and no shunt in 2 cases.The pulmonary arterial pressure was 65-120 (82 ± 14) mm Hg ( 1 mm Hg =0.133 kPa).All patients received surgical repairs under cardiopulmonary bypass and were treated preoperatively with oxygen inhalation therapy,oral intake of beraprost sodium or silaenafil respectively according to the degree of pulmonary hypertension.During cardiopulmonary bypass,pulmonary artery perfusion was performed with protective solution containing ulinastatin for lung protection.Vasoactive drugs were routinely administrated postoperatively.Results Thirty-two cases underwent the surgical treatment successfully with their postoperative pulmonary arterial pressure decreased 20 -40 mm Hg and 2 cases died of severe low cardiac output syndrome and fatal arrhythmia.The mortality was 6.25％(2/32).ConclusionComprehensive perioperative management followed by radical operation can achieve a good clinical result on congenital heart disease combined with pulmonary hypertension.

Objective To summarize the results of valve re-operative cases after cardiac valve replacement, to find the better re-operative time, and to estimate the re-operative methods and influencing factors of the operation. Methods Thirteen valve re-operative cases after cardiac valve replacement from October 2008 to February 2010 were retrospectively studied. According to NYHA classification, 9 cases belonged to class Ⅳ, and only 4 cases belonged to class Ⅲ preoperatively. Mitral valve replacement (MVR)was performed in 7 cases, aortic valve replacement (AVR) in 3 cases, MVR + AVR in 3 cases. Results The early-stage postoperative mortality was 7.7%( 1/13),and the reason was low cardiac output syndrome. Two cases who underwent re-operation and re-intubation respectively after operation for hemorrhage were improved after treatment. Twelve cases were discharged in 3-6 weeks after heart valve surgery and all were followed up for 6-15 months. The cardiac function of all the discharged patients recovered well and no death occurred during follow-up. Conclusion The key factors to reduce the death of re-operation are improving preoperative heart function,setting up extracorporeal circulation as soon as possible,consummating myocardial preservation,perfecting operating skills,correcting low cardiac output syndrome in time and preventing complications.

Objective:To investigate and evaluate the effect of antibacterial agents clinical use and management training for medi-cal institutions in Hubei province in order to promote rational antibacterial drug use. Methods:A questionnaire was designed, inclu-ding basic conception, medication principle, mechanism and medication feature etc. The data were studied by SPSS 13. 0 software to analyze the knowledge level of antibacterial agents in medical staffs. Results: Medical staffs had good acquisition in the knowledge points involved in choice questions. The correct percentage of each scoring in essay questions differed considerably within the range of 7. 88%-99. 01%. Management rules could be well understood, while the definition of antibacterial drugs and the difference between antibacterial drugs and antibiotics were paid little attention. Conclusion: The overall knowledge level of rational antibacterial agents use in the trainees is promising with comprehensive understand of the management rules. It's necessary to distinguish antibacterial a-gents from antibiotics more clearly.