Objective To probe the effects of hypothermia and St Thomas Hospital Ⅱ cardioplegia on immature myocardium.Methods To observe the change of hemodynamics,myocardial enzyme in the coronary effluent and myocardial biochemistry of the perfused immature rabbit heart in vitro after two or four hours ischemia at 14 degrees centigrade.Results There were no significant differences in post ischemic hemodynamics,myocardial enzyme in the coronary effluent and myocardial biochemical parameters of the perfused immature heart The myocardial protective effect provided by St.Thomas Hospital Ⅱ cardioplegia was worsen than that of hypothermia alone,marked by the elevated myocardial enzyme leakage and the decreased hemodynamics.Single dose perfusion was better than multi dose perfusion by characteristics of decreased enzyme leakege and good post ischemic hemodynamics.Conclusions Hypothermia alone can provide immature heart with satisfactory myocardial protection.St.Thomas Hospital Ⅱ cardioplegia can not afford good myocardial protection to immature heart and enhance the myocardial protective effect provided by hypothermia.The myocardial protection effect is better provided by single dose perfusion than by multi dose perfusion

Objective To summarize the results and experience of coronary artery bypass grafting for coronary artery disease.Methods From Jan. 2001 to Apr. 2002, 218 patients underwent coronary artery bypass grafting. Male 143, female 75. Coronary artery bypass grafting with extracorporeal circulation(ECC) in 152 patients, off-pump coronary artery bypass grafting in 66 patients. Surgical technique, perioperative treatments, death causes and complications were analyzed in all cases.Result 5 patients died in hospital, mortality was 2.3%(5/218), others had favorable outcomes.Conclusions Strict mastery of surgery indictions, advanced oprative methods, excellent myocardial protection and perfect perioperative treatments are pivotal factors of CABG, the efficacy and safety of coronary artery bypass grafting are satisfactory.

Objective To evaluate the results of coronary artery bypass grafting in forty-one senile cases no less than seventy years old with coronary heart disease. Method Retrospectively analyzed the operative results of 41 cases of CABGs (17-case of OPCABs and 24-case of conventional CABGs(CCABGs))with the age no less than 70 years old from Dec.20 2000 to Jan.31 2002.Results The average bypass grafts per patient was 2.1?0.6 in OPCAB group and 3.4?0.7 in CCABG group(P

Objective To study the changes of the myocardial cell apoptosis in myocardial infarction of rabbits. Methods The model of rabbit with myocardial infarction was established.HE staining,TUNEL staining, immunohistro-chemistry staining, ultrathin section for electron microscope and DNA electronic gel phorensis were performed in samples of ischemia or infarction in different times.The position of apoptotic myocytes in different phases of ischemia were observed by light microscope and electronic microscope. Results After 30 minutes to 4 weeks ischemia.there were a few TUNEL positive nucleus of myocytes in the margin area of myocardial infarction;HE staining-found typical expressions of apoptosis,such as chromosome conglomeration,chromosome gathered at the edge or chromosome aggregation,dark-stained nucleus,cell shrinkage,were obvious in 4-8 hours.A lot of positive nucleus of myocytes stained by TUNEL were found in the early stages of myocardial ischemia in myocardial infarction.gradually ascended and then became hardly visible from 8 hours to 3 days.Nucleus swelling,karyorrhexis and karyolysis were found in the area of myocardial infarction.then cells were broken.DNA agarose electrophoresis found DNA fragment of most myocytes in 30 minutes of ischemia,just a few cardiocytes decomposed to the big segments.At 4hours of ischemia the most cardiocytes decomposed to big segments,and there were a blurry"ladder"in DNA strand breaks from 8 hours to 1 day.It showed that apoptotic cardiocytes existed in the margin area of myocadial infarction. Conclusions There are cardiocytes apoptosis in the margin area of infarction from 30 minutes to 4 weeks after myocardial ischemia.Maybe it relates to the reperfusion caused by collateralization establishment or infiltration from circumference.

Background and objective Lymphatic metastasis is the most important way for the spread of lung cancer and is one of the important factors affecting the prognosis. Existing studies showed that compared to middle or lower lobe NSCLC, upper lobe non-small cell lung cancer (NSCLC) has a higher probability of occurring regional mediastinal lymph node metastasis. hTe purpose of this study is to research the prognostic factors and lymphadenectomy of stage Ib upper lobe NSCLC. Methods A retrospective study of 147 consecutive subjects (76 and 71 for right and letf upper lobe NSCLC respec-tively) who had undergone curative resection for stage Ib upper lobe NSCLC was performed. A total of 925 lymph nodes were removed during the surgery in all enrolled patients and a total of 491 mediastinal lymph nodes (266 and 225 for superior and inferior mediastinal lymph nodes respectively) were removed. Kaplan-Meier product method and Log-rank test were used for univariate survival analysis and Cox regression model was used for multivariate survival analysis. Results ①Both univariate and multivariate analysis showed that age, tumor size and number of removed superior mediastinal lymph node stations were the important prognostic factors of stage Ib upper lobe NSCLC;②For stage Ib right upper lobe NSCLC, station 4 lymph node was of statistical signiifcance to the prognosis (P=0.021);while for stage Ib letf upper lobe NSCLC, station 5 lymph node was of statistical signiifcance to the prognosis (P=0.024). Conclusion In surgically treated stage Ib upper lobe NSCLC patients, age, tumor size and number of removed superior mediastinal lymph node stations are the important prognostic factors. And in this kind of patients, lobe-speciifc systematic lymph node dissection may be a more effcient procedure during the surgery.

Objective: Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province. Methods: A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data. Results: The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P < 0.01 ). The length of hospital stay [12 (9, 17) d] in the triple combination antiviral drug group was also shorter than that in the dual combination antiviral drug group [15 (10, 18) d] (H = 2.073, P < 0.05). Comparing the antiviral treatment which was started within 48 hours, 3-5 days and > 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05). Conclusions The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.