In this study an acute rejecting model of heterotopic rat heart-lung transplantation was established by using simplified technique of end to side anastomosis of donor ascending aorta with recipient abdominal aorta.The measurements of tumor necrosis factor alpha(TNF-α)in serum of rats by Sandwich-ELISA method were taken on the 3rd,5th,7th days respectively after operation.The results of this study with histological examination showed that TNF-α serum levels were increased during acute rejection episodes.and it might be a useful indicator for diagnosis of allograft rejection.

Objective To study clinical manifestations, diagnosis, treatment, as well as effect of surgical operation, of primary mediastinal large B-cell lymphoma (PMBCL).Methods Data of 19 patients of PMBCL with complete clinical and pathological records hospitalized at Peking Union Medical College Hospital during 1998 to 2008 were retrospectively reviewed and analyzed.Kaplan-Meier method was used to estimate their survival time and survival rate in comparison of efficacy in those with surgical operation to those without it.Results Overall three-year survival rate was 54% for all the 19 patients, 55% for those with surgical operation and 54% without it, respectively, with an average survival time of 44 months, 44 months for those with surgical operation and 42 months without it, respectively, but not reaching at statistical significance.Symptoms of superior vena cava syndrome in five cases at admission relieved immediately after surgical operation, but symptoms of superior vena cava syndrome in three of nine cases in non-surgical group relieved gradually one to three weeks after chemotherapy.Conclusions Surgical operation has no significant effect on survival in patients with PMBCL, but it can relieve syndrome of superior vena cava syndrome and provide accurate pathological diagnosis.

Aim To evaluate neuroprotective effects of stearic acid on primarily cultured hippocampal neurons and to study the mechanism of neuroprotection afforded by stearic acid.Methods Primarily cultured hippocampal neurons were insulted by OGD(oxygen-glucose deprivation),H_2O_2,glutamate and NaN_3;MTT assay was utilized to evaluate cell viability;Inhibitors of PPAR?and PI-3K signal pathway were used to study mechanisms of neuroprotection of stearic acid.Results Compared with control neurons,A_(570) in MTT assay were increased significantly by stearic acid in hippocampal neurons insulted by OGD(oxygen-glucose deprivation),H_2O_2 and glutamate(P

Acute respiratory failure (ARF) after operation for esophageal carcinoma is a serious challenge to medical management and usually accompanied by a high mortality rate. This paper present author's experience on the management of 10 such cases. It is emphasized that advanced age, long-history of smoking, COPD are predisposing factors and in-trathoracic surgery and its complication may trigger the ARF,which usually occurs within 48-72 hours after operation. Besides assist mechanical ventilation, thorough clearance of the secretion from the respiratory tract, control of pulmonary infection and early eradication of the intrathoracic complications are the key points of the successful treatment. Preoperative pulmonary functional studies with careful analysis in correlation with patients condition is mandatory especially in elderly patients. Prevention is more important and valuable than treatment for the patients with postoperative acute respiratory failure.

Objective To study the enhancing effect of ultrasound plus microbubble on small interference RNA(siRNA)transfection in vitro and in vivo.Methods Human vascular epithelial growth factor(VEGF)siRNA with 2'deoxy modification(VEGF 2'-eoxy siRNA,VdsR)was used.The human CNE cells(fromnasopharyngeal carcinoma)line was used for in vitro cell-based experiments and in vivo mouse xenograft model.Two different microbubble agents.BR14 and Levovist.were used together with the RNA transfection reagent RNA-mate.ELISA and RT-PCR assays were used to assess VEGF gene expression.Immunohistochemical staining (IHC)was performed to assess CD31 expression in xenograft tumors.Results VdsR transfection in CNE cells abolished VEGF expression as determined by ELISA experiments.In the first mouse xenograft experiment,ultrasound exposure dramatically enhanced VdsR-mediated tumor inhibition.In the second mouse xenograft experiment,when VdsR was mixed with the microbubble reagents and then injected into xenografts,ultrasoundexposure significantly reduced tumor growth in BR14-mixed VdsR group but not in the Levovist-mixed VdsR group compared to the control.RT-PCR experiments demonstrated that VEGF expression in ultrasound-exposed tumors was significantly lower than that in the control.Meanwhile,VEGF expression in the tumor tissue treated by BRl4-mixed VdsR declined as compared with the controls.Tumor vascular density as measured by CD31 immunostaining was significantly decreased in ultrasound-exposed tumors compared to the control.Conclusions Ultrasound exposure and/or microbubble can significantly enhance delivery and the efficiency of VdsR-mediated anti-tumor effects,and should be a location-specific enhancement approach for siRNA-based anti-cancer therapy.

BACKGROUNDLung cancer is still the most common cause of cancer death. Although it is reported that the 5-year survival rate for lung cancer has been greatly increased, surgical results are controversial. The aim of this study is to investigate and evaluate the improvement of survival of lung cancer surgically intervened in PUMC hospital during the last 15 years.

METHODSFrom January 1989 to December 2003, 1574 cases of lung cancer underwent surgical treatment and obtained follow-up. The results were retrospectively a- nalysed . All cases in this series were divided into two groups according to time, group A (1999-2003) and group B (1989-1998), and the differences of survival rate between group A and group B were compared.

RESULTSThe morbidity and mortality of group A decreased significantly when compared to group B (11.2% vs 19.2%, 1.06% vs 1.93%, respectively, P < 0.01). However, the 3- and 5-year survival rates had been obviously raised from 42.35% to 56.07%, and from 28.46% to 38.99%, respectively (P < 0.05 ). A significant improvement in survival was observed in patients with stageI, stage II and stage IIIA, but not in stage IIIB and stage IV. Also, the patients with lobectomy had better results but those with exploratory thoracotomy, limited resection, pneumonectomy and sleeve resection did not show better results.

CONCLUSIONSLobectomy associated with systematic dissection of mediastinal lymph nodes has become the standard mode for the resectable lung cancer. Combination of complete resection and lymph nodes dissection, with postoperative adjuvant chemotherapy based on platinum/3rd generation medicine, have preliminarily been justified and proved an important approach for effective improvement of long-term survival of lung cancer.

A new method was established for the direct, rapid and quantitative analysis of pesticide residues, dimethoate chlorothalonil and malathion by low temperature plasma ( LTP) ionization miniature ion trap mass spectrometer. The LTP ionization probe and sample inlet of ion trap mass spectrometry were enclosed in a metal cavity. With non-contact heating, the samples placed on the sample platform were desorbed into gaseous phase and ionized by LTP ionization probe. The results showed that closed ionization had an edge over the opened ionization. The quantitative analysis of 3 pesticides within the range of 0. 5-10 mg/L was realized by optimizing heating time and flow rate of air, and the relative standard deviations of signal intensity is less than 11%. LODs of pesticide, which were obtained within 5 s, were as low as several hundred pictograms. The results showed that the method could be used for the analysis of pesticide residue on green and organic fruits or vegetables.

OBJECTIVETo understand the clinical manifestations, diagnostic methods, surgical management and prognosis of retrosternal thyroid masses in various pathological types.

METHODSSixty-four cases of retrosternal thyroid masses with surgical intervention were analyzed retrospectively.

RESULTSTrachea-compressed symptoms (65%) and shadows beside the trachea at thoracic inlet (94%) were the most common clinical findings, chest X-ray (70%) and CT scan (96%) had higher diagnostic rate. No death occurred during operation or hospitalization among these patients. Total complications occurred in 15.7% cases (11/70) (including 3 preoperative cases with hoarseness) and postoperative pathological results were mainly multinodular goiter (54.7%), thyroid adenoma (21.9%) and thyroid carcinoma (15.6%) (including local carcinomatous change).

CONCLUSIONSDiagnosis of retrosternal thyroid mass can be correctly made by chest X-ray and CT scan. Most operations on retrosternal thyroid masses can be performed safely through cervical incision with minimal morbidity and low recurrence rate. Retrosternal thyroid carcinoma was potentially invasive and could hardly be resected completely, hence with poor prognosis.

Adenoma ; diagnosis ; surgery ; Adult ; Aged ; Carcinoma ; diagnosis ; surgery ; Female ; Goiter, Nodular ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thoracotomy ; Thyroid Gland ; diagnostic imaging ; surgery ; Thyroid Neoplasms ; diagnosis ; surgery ; Thyroidectomy ; Tomography, X-Ray Computed

Laparoscopic radical gastrectomy for gastric cancer has been widely applied in clinical practice, and its indications have been extended from early gastric cancer to advanced gastric cancer. It is acknowledged that laparoscopic radical gastrectomy is technically challenging because of the complexity of anatomy, rich blood supply, and extensive lymph node dissection. This paper primarily intends to share the experience of laparoscopic radical D2 gastrectomy for distal gastric cancer with details of choosing the location of Trocar, surgical approaches and the sequence of lymph node dissection. All the surgeries were performed at Department of General Surgery and Gastrointestinal Surgery, Guangdong General Hospital. The finding suggests that a correct laparoscopic Trocar placement is the foundation of adequate surgical field visualization. Under most circumstances, the observation hole should be around 2 cm below the umbilicus and the operating hole should be close to the bilateral clavicle midline. Furthermore, proper surgical approach and sequence of lymph node dissection are the prerequisites for successful laparoscopic radical D2 gastrectomy, as well as the reassurance of dissecting lymph node safely and comprehensively. The position of surgical team adopted in our center is that the surgeon stands to the left of the patient, with laparoscope operator stands in between patient's legs while the first assistant positions himself opposite the surgeon on the right side of the patient. This position correlates to the rules of sequential lymph node dissection, which is "from left to right", "from proximal to distal" and "from inferior to superior". Therefore, it is conductive to inferior and superior pylorus region dissection and it can effectively prevent subsidiary-injury. In our center, the procedure of lymph node dissection has been standardized: the initial step is to undergo station 4sb dissection and greater gastric curvature clearance; then change the patient's position to clean the sub-pyloric lymph node region and cut off the duodenum by linear stapler; followed by the clearance of inferior region of the pylorus and the upper margin of the pancreas; in the final step, the first and the third groups of lymph node dissection is performed. Although varied surgical approaches and sequences of lymph node dissection are applied in different hospitals, the techniques required for laparoscopic D2 radical gastrectomy for gastric cancer are sophisticated and advanced in general. Radical lymph node dissection is complicated, urging surgeons to familiarize themselves with the anatomy of gastric peripheral vascular system and characteristics of lymph node drainage. By designing and implementing effective strategies, such as formulating a regular team, positioning surgical team reasonably, changing a patient's posture during operation, choosing an appropriate surgical approach and following a logically sequence of lymph node dissection, surgeons can standardize the complete surgical procedure, which ultimately reduces bleeding during surgery and shortens the operative time.

OBJECTIVETo establish a reasonable protocol for interventional treatment of hepatocellular carcinoma (HCC).

METHODSThe data of 1 000 HCC patients treated by different kinds of interventional treatment were reviewed with their results of biochemistry, imaging, pathology and survival rate evaluated. The value as well as the pros and cons of these various kinds of interventional treatment were compared in order to find an optimum protocol.

RESULTSSegmental-transcatheter oil chemoembolization (S-TOCE) was much effective eradicate the tumor yet inflicting less damage on the noncancerous hepatic tissue and giving much higher survival rate than the conventional transcatheter oil chemoembolization (C-TOCE). Percutaneous ethanol injection (PEI) played an important role in eradicating the residual tumor and improving the survival rate without damaging the noncancerous hepatic tissue. The survival quality or survival rate could be improved by choosing different ways of interventional treatments to cut down the complications.

CONCLUSIONThe selection of different interventional treatments should be done according to the size and type of HCC. Active management is indicated for different complications presenting along with HCC.

Carcinoma, Hepatocellular ; mortality ; therapy ; Chemoembolization, Therapeutic ; Humans ; Liver Neoplasms ; mortality ; therapy ; Retrospective Studies ; Survival Rate