The objective of this retrospective study was to evaluate the myocardial protection of different periop erative procedures in 100 cases with heart-valve replacement (HVR) between 1980 and 1992. Before Feburary. 1989. HVRs of 48 cases (group Ⅰ) were undertaken with hypothermia (28C=30C) and cold cardioplegic solution (4C. 500ml). under morphine-diazepam-pancuronium anesthesia: following cardiac resuscitation, the procedures were performed including blood transfusion, diuresis, supplemental KCI. inotropic support with dopomine, norepincphrine and aramine. and continuous mechnical ventilation. Since 1989, the procedures were increased to be conducted in 52 cases (group Ⅱ) as followed: A. preoperative managements for achiving the optimum status of cardiac function: 1. oxygen therapy by mask. 2. antirhenmatic treatment for patients aged less than 35 years. 3. oral isosorbide and captopril for pulmonary hypertension, 4, infusion with fructose 1.6-diphusphatc and glucose-insulin-KC1 mixture. 5. clinical dose of digitora and diuretics for cardiac failure; B. methods during surgery: 1. anesthesia was induced with fentanyl, midazolam and pancuronium. and maintained with inhalation of nitrous oxide and infusion of fentanyl at 30-35?g/kg/min, 2, hy pothermia (24C-27C) and cold cardioplegic solution(600-1000ml) 3. immediately before the blockage of aorta was overcome. the artificial perfusion blood pressure was reduced; afterwards, it was gradually recovered, in order to prevent myocardium from injury of reperfusion. 4. intra-and extracoporal circulations worked together over half of blokage time of arota, to improve myoardial oxygen delivery; C. treatments in early postoperative stage: 1. continuous positive end-expiratory pressure ventilation, 2. infusion with magnesium-potassium aspartyl: and the others were similar to those before 1989. As compared with those in group 1. the rate of spontanous restoration of beats increased significantly (P

Objective To investigate the complications of gynecological laparoscopies and its related fac-tors. Methods The clinical data of 8700 cases with laparoscopic surgeries from August 2003 to August 2008 were retrospectively analyzed. Results Complications occurred in 259 cases,with a overall complication rate of 2.98%, the serious complication occurred in 37 cases(0.43%), and surgical treatment was needed in 21 cases. The compli-cations included: 129 complications related to puncture and pneumoperitoneum(including subcutaneous emphysema and abdominal wall congestion) ,20 related to bleedings, 17 related to injuries ,26 related to postoperative infections. Conclusion Operative gynecologic laparoscopy-induced complications were associated with operation difficulty, so great attention should be paid. In order to reduce the risks of laparoscopic surgery, indications should be selected cor-rectly,and procedures should be operated carefully.

Objective To investigate the role of tumor necrosis factor (TNF)-alpha-induced protein 8-like 2 (TIPE2) for regulating the macrophage polarization in systemic lupus erythematosus and its curative effects on experimental SLE mice.Methods The mice were treated with activated lymphocytes derived DNA (ALD-DNA) for inducing mice model,randomly divided into AAV-scr control group and AAV-TIPE2 experimental group,and injected with AAV-TIPE2 or AAV-scr virus solution from the tail vein of mice.The expression of TIPE2 mRNA and protein in polarized macrophages,serum dsDNA antibody titer,urine protein and renal pathological index were detected.Results (1) The TIPE2 expression level of TIPE2 mRNA and protein in AAV-TIPE2-transfected cells was 13.5±1.6 times and 10.8±1.6 times of AAV-scr control group respectively.(2) M2 macrophage specific molecule MGL+ was 59.6% in AAV-TIPE2 group and MGL + cells in the AAV-scr group was 8.4%.M2/M1 odds ratio of AAV-TIPE2 experimental group to AAV-scr control group was 16.(3) The recombinant TIPE2 adenovirus related vector could stably expressed in transfected HEK-293.In vitro and in vivo experiments confirmed that AAV-TIPE2 was able to induce M2 polarization of macrophages in ALD-DNA-induced lupus mice.(4) The serum anti-dsDNA antibody,urinary protein and renal pathology in the AAV-TIPE2 group were significantly lower than those in the AAV-scr group(P<0.01).Conclusion TIPE2 alleviates the disease condition of ALD-DNA induced SLE mice through induction of macrophage polarization to M2 phenotype,which may be used as a promising therapeutic method for ALD-DNA induced SLE mice.

BACKGROUND:18-Alkylated-chitosan has been proved to exhibit a good coagulation capacity through hydrophobic modification. OBJECTIVE:To improve the adhesion between the material and the wound through the introduction of alkylated-chitosan molecules. METHODS:The alkyl group was introduced in the chitosan by potentiodynamic method to prepare the alkylated-chitosan with different substitution degrees (7%,16%, 26%and 40%), and then their structure, viscosity, porosity, water absorption, contact angle and in vitro coagulation capacity were detected. Thirty New Zealand rabbits were enrol ed, modeled into the left femoral artery hemorrhage, and randomized into six groups, including four experimental groups, positive control and control groups, fol owed by treated with alkylated-chitosan sponges with different degrees of substitution, absorbable hemostatic gauze and chitosan sponge, respectively. Afterwards, the blood loss and clotting time were observed. RESULTS AND CONCLUISON:With the degree of substitution increased, the viscosity of alkylated-chitosan increased firstly and then decreased, the porosity and water absorption decreased gradual y, and the contact angle on a rise. Compared with chitosan, different alkylated-chitosans showed a better henostatic effect in vitro, especial y the alkylated-chitosan with 16%substitution degree. The blood loss and clotting time in the experimental groups except that the alkylated-chitosan with 7%substitution degree were significantly lower than those in the control group (P<0.05);the bold loss in the alkylated-chitosan with 40%substitution degree group was significantly lower than that in the positive control group (P<0.05). These findings suggest that the alkylated-chitosan with 40%substitution degree exhibits the best hemostatic effect in vivo.

Objective To explore the potential association of HLA-A alleles and genetic susceptibility with systemic lupus erythematosus (SLE). Methods Polymerase chain reaction-sequence specific primer (PCR-SSP) was used to analyze the distribution of HLA-A alleles among 106 patients with systemic lupus erythematosus and 122 healthy persons. Results Nineteen out of twenty-four kinds of HLA-A alleles were found from the specimens, including 18 kinds in SLE specimens, and 15 kinds in control specimens. Among them, HLA-A*11 allele was positively associated with SLE (RR = 2.4380, EF = 0.1502, ?2 = 12.2440, P = 0.0005, Pc = 0.0095). For A*01 and A*24, although the P values were less than 0.05, the Pc values were more than 0.05 (0.9462 or 0.2356, respectively). Conclusions The results indicate that HLA-A*11 may be the susceptible allele or may be closely linked with the susceptible genes in Chinese SLE patients.

Objective To investigate the effect of intensive control of residual amount in stomach on prevention of ventilator associated pneumonia(VAP)during the process of enteral nutrition. Methods 96 patients with mechanical ventilation(MV) more than 48 hours were randomly divided into the case group and the control group, they were treated with intensive control and common control of residual amount in stomach respectively. The incidence rate of VAP, mortality rate, time of ventilation and hospitalization time were compared between the two groups. Results The incidence rate of VAP was 20.83% in the case group and mortality rate was 18.75%,the time of MV was(15.21±2.36)days, the hospitalization time was(22.38±12.34)days. The incidence rate of VAP wag 39.58%.mortality rate was 39.58%,the time of MV wag(19.85±4.58)days, the hospitalization time was(29.46±15.24)days in the control group. Conclusions Intensive control of residual amount in stomach could be helpful to decrease the incidence of VAP and mortality rate of patients with mechanical ventilation using nasal feeding, also shorten the time of MV and the hospitalization time.

Objective To investigate the diagnostic value of UL-16 binding protein 2 (ULBP-2,macrophage inhibitory cytokine-1 (MIC-1) for pancreatic cancer.Methods The serum samples of 152pancreatic cancer patients,20 precursors of pancreatic cancer,91 chronic pancreatitis patients and 96 age/sexmatched healthy persons were collected.The serum ULBP-2 and MIC-1 levels were determined by using the ELISA kit and were compared with level of CA19-9.A receiver operating characteristic (ROC) curve was constructed to evaluate their diagnostic values for pancreatic cancer.Results The serum levels of ULBP-2 in patients with pancreatic cancer,precursors of pancreatic cancer,chronic pancreatitis and healthy persons were (219.9 ± 182.5),(62.6 ± 11.4),(68.4 ± 36.8),(76.5 ± 40.9) μg/L,the corresponding values of MIC 1 were (3521.3±3903.4),(973.6±589.0),(959.6±879.0),(427.6±317.0) μg/L,while the corresponding values of CA19-9 were (1448.8 ± 3707.0),(12.0 ± 9.3),(38.2 ± 139.0),(7.7 ± 5.0)kU/L.The parameters in pancreatic cancer patients were significantly higher than those in control group (x2 =40.628,71.662,45.505,15.827,36.433,63.494,26.264,73.427,49.088,P ＜ 0.01).The area under ROC curves(AUC) of ULBP-2,MIC-1,CA19-9 were 0.909,0.864,0.818,and ULBP-2 was superior to CA19-9 and MIC-1,however the combined measurement of three markers produced the highest diagnostic yield(AUC =0.982).For early stage pancreatic diseases (precursors to pancreatic cancer and IA stage pancreatic cancer),AUC of ULBP-2,MIC-1,CA19-9 were 0.506,0.837,0.684,MIC-1 was superior to ULBP-2 and CA19-9,however the combined measurement of MIC-1 and CA19-9 produced the highest diagnostic yield(AUC =0.897).Conclusions Serum ULBP-2,MIC-1 levels are significantly elevated in pancreatic cancer patients.The combined measurement of ULBP-2,MIC-1 and CA 19-9 can increase the diagnostic yield for pancreatic cancer.

Objective To investigate the clinical significance of serum transforming growth factor-β( TGF-β),tumor necrosis factor-α( TNF-α) and interferon-γ( IFN-γ) levels in patients with pre-eclampsia. Methods Thirty-two cases of maternal pre-eclampsia( 22 cases were mild pre-eclampsia,10 cases were severe pre-eclampsia),30 cases of gestational hypertension and 30 cases of normal mothers were selected as our subjects. Serum TGF-β,TNF-α IFN-γ levels were detected. Adverse pregnancy outcomes in patients were collected and analyzed. Results Serum TGF-β,TNF-α,IFN-γlevels in patients with severe pre-eclampsia were (90. 4 ± 23. 4)μg/L,(84. 5 ± 13. 6)μg/L and(146. 5 ± 13. 4)μg/L respectively,significantly higher than that in normal mothers((11. 3 ± 3. 7)μg/L,(5. 6 ± 1. 2)μg/L and(82. 5 ± 19. 4)μg/L),the gestational hypertension group(( 35. 3 ± 8. 4 )μg/L,( 10. 4 ± 2. 9 )μg/L and( 96. 4 ± 15. 8 )μg/L ),and mild pre-eclampsia group((76. 5 ± 15. 4)μg/L,(26. 5 ± 3. 2)μg/L and(120. 4 ± 20. 5)μg/L),and the difference were significant(F=11. 363,15. 982,7. 431;P﹤0. 001). Serum TGF-β,TNF-α and IFN-γ levels in mild pre-eclampsia were significantly higher than those in normal mothers and gestational hypertension patients( P﹤0. 05). Incidence of preterm delivery in patients with high TGF-β,TNF-α,IFN-γ expression was significantly higher than patients with low expression(7 cases vs. 2 cases;χ2 =4. 037,P=0. 044). Incidence of in patients with high FGR,TGF-β,TNF-α expression was significantly higher than patients with low expression( 6 cases vs. 1 case;χ2 =4. 969,P =0. 025 ). Conclusion Detection of maternal serum cytokines can evaluate the severity of pre-eclampsia to a certain extent and predicted adverse pregnancy outcomes.

BACKGROUND:There is no effective drug for idiopathic pulmonary fibrosis (IPF), because of a lack of the animal model imitating the complete pathogenesis of human IPF. Therefore, it is critical to establish an ideal animal IPF model used for investigating the underlying pathogenesis and developing a kind of effective drug. OBJECTIVE:To establish an animal model that can mimic more characters of human IPF. METHODS:Seventy male C57BL/6 mice were randomly divided into two groups, fol owed by subjected to the intraperitoneal injection of bleomycin (35 mg/kg) on days 1, 4, 8, 11, 15, 18, 22, and 25, twice (group A) or once (group B) a week. Mice were sacrificed at 2, 4, 6, 8, and 10 weeks after the eighth injection, and the lung tissues were moved used for hematoxylin-eosin, Masson and immunohistochemical stainings. RESULTS AND CONCLUSION:There were various degrees of alveolitis and pulmonary fibrosis in the two groups at different time points after the last injection. The scores of alveolitis and pulmonary fibrosis in the group A began to gradual y increase from the 2nd week and reached the highest level at the 6th-8th weeks until the 10th week. In contrast, the scores of alveolitis and pulmonary fibrosis in the group B peaked at the 2nd week, then fluctuately decreased, and were significantly lower than those in the group A at the 6th week (P<0.05). Immunohistochemistry showed that type I col agen deposition was mainly distributed in the subpleural region, peri-vascular region and alveolar septa, which was consistent with Masson staining findings. The expression levels of transforming growth factorβ1 (TGF-β1) andα-smooth muscle actin (α-SMA) in the regions developing alveolitis and pulmonary fibrosis were significantly increased. In the group A, the expression levels of type I col agen, TGF-β1,α-SMA, and the hydroxyproline content in the lung tissues reached the peak level at 6-8 weeks. However, in the group B, al above indicators reached the highest level at the 2nd week, but gradual y decreased thereafter. At the 4th week, the expression Levels of TGF-β1 andα-SMA in the group B were significantly lower than those in the group A (P<0.05). At the 6th week, the hydroxyproline and type I col agen levels in the group B were significantly lower than those in the group A (P<0.05). In conclusion, the mouse model of pulmonary fibrosis induced by intraperitoneal injection of 35 mg/kg bleomycin twice weekly can be used to mimic the repetitive wound healing process, pathological morphology and cytokine changes of human IPF, which is prone to administration, with better stability and repeatability. This model is of great significance for the study on IPF. Subject headings:Disease Models, Animal;Pulmonary Fibrosis;Bleomycin

Objective To investigate the experience of laparoscopic complete mesocolic excision ( CME) for colon cancer. Methods There were102 patients,of which 68 cases with colon cancer were performed laparoscopic CME,34 cases were treated by traditional surgery. The 2 groups were reviewed retrospectively. Results As compared with the traditional group,the operation time,time of first flatus,hospital stay in the CME group increased. The postoperative suction drainage was decreased in CME group. The CME group had less blood loss and more mean lymph nodes clearance than the traditional group. The complication incidences had no significant differences between 2 groups. Conclusion Laparoscopic CME for colon cancer,with the advantages of less tumor spreading and more thoroughly lymph node dissection,is worthy of clinical application.