The paper reports the myocaraial protection in 590 cases having undergone open heart surgery with CPB. The following methods were administered for heart preserving: Lowering the blood temperature to 24～27℃ under CPB; perfusing coronary arteries with cardioplegic solution(high potassium at 4℃) every half an hour; Keeping hemodilution at the middle degree(HCT: 20～25%, Hb: 80g/L); Lowering the temperature of the heart surface to 20～9℃ with snow ice. Automatic rebeating of the heart was in 413(68%) cases and defibrillative rebeating in 177(32%). Th method was characterized by complete hypo-temperature of the heart, decreaseing oxygen consumption and micro-thrombus etc. And therefore it made the automatic rebeating rate higher.

The potassium content in serum, red cells andsome factors involved in hypopotassium were ob-served in 30 cases with open heart surgery. Ac-cording to the results, we conclude that (1) Hy-popotassium tendency before and during cardiopul-monary bypass was mainly produced by the potas-sium moving into the red cells from the serum. Af-ter Cardiopulmonary bypass it was mainly owing tothe excretion of potassium through the urine. (2)The potassium shifting into the red cells waschiefly affeced by the bypothermia, pH, and perfu-sion time. (3) The red cell potassium lost whenplasma potassium value set below 4. 0 m mol/L.1. 56 m mol/kg of potassium administered was atleaset reqired to maintain plasma potassium leverover 4. 0 m mol/L.

Objective To investigate the influence of Bisoprolol on plasma brain natriuretic peptide level for congestive heart failure.Methods 84 patients of chronic congestive heart failure were selacted as study object.All patients in the conventional anti-heart failure therapy based on the application of bisoprolol,2.5mg/d,one time of day,adjusting the 5 ～ 10mg/d,one time of day,according to the situation of patients,the heart rate,blood pressure,changes in ejection fraction,and BNP before and after treatment were observed.Results The BNP level of 84 patients decreased as the heart function gradually increased(t =4.241,4.573,4.074,7.328,all P ＜ 0.01).After treatment,heart rate,blood pressure,left ventricular ejection fraction was significantly higher than that before treatment (t =3.585,3.245,3.347,all P ＜ 0.05).After treatment,BNP level was significantly lower(t =4.876,P ＜ 0.01).Conclusion BNP level in patients with congestive heart failure could reflect the level of heart function,the application of bisoprolol in patients with congestive heart failure could improve cardiac function and reduce BNP levels in patients.

The electromicroscopic observation of atrialbiopsy was carried out in 10 patients with ventric-ular septal defect (VSD) and middle, severe pul-monary hypertension (PH). The observation sug-gests that there are myofibrillar lysis to disappearwith various degrees, dilated rough endoplasmreticulum and the increase in lipofuscin granulesand lipid droplets; mitochondral hyperplasia, theirsize and shape being different, disorganizing of mi-tochondria, disintegration of cristae, mitochondralretrograde degenration and decreased matrix elec-tron density. The dilated intercalated discs and in-crease in myocardial fibrous tissue were found inpart of patients. These structural changes areprobably due to chronic myocardial ischemia.

Objective To discuss the role of endothelicyte activation in the development of pulmonary hypertension (PH) and vascular remodeling. Methods A total of 10 patients with simple ventricular septal defect(VSD)of congenital heart disease(CHD)were choosen as controls, and 30 patients with different degree of PH were studied. Plasma levels of interleukin-1(IL-1), endothelin-1 (ET-1) and nitric oxide (NO) which represented the degree of endothelicyte activation were measured by radioimmunoassay and commercial available kit. The specimens taken from right lung before cardiopulmonary bypass were fixed by formaldehyde solution. The percentage of vascular wall thickness/vascular external diameter (WT/D) and the percentage of vascular area/total vascular area (WA/A) which represented vascular remodeling, were measured by QTM970 analysator. Results Compared with patients of simple VSD, the plasma levels of IL-1, ET-1/NO and WA/A, WT/D increased in patients with PH. Conclusion The activation of endothelicytes and imbalance of ET/NO play an important role in the development of PH and vascular remodeling. Positive correlations were seen between IL-1, ET-1/NO and WA/A, WT/D(P

Objective To obtain the effective characteristic information for the standardization of diagnosis of traditional Chinese medical(TCM) syndrome in rheumatoid arthritis(RA).Methods Fifty-four items of symptoms and signs in RA patients were input into the computer,and Mahalanobis distance discriminant analysis(DDA) was used for the selection of effective indexes.Results According to the weight value and the result of T test,17 items from 54 had the highest rate of discrimination accuracy,up to 96.5%.Conclusion The results of computerized pattern recognition for the syndrome diagnosis of RA are consistent with the clinical diagnosis,which indicates that computerized pattern recognition can be used for the standardization of syndrome diagnosis of RA.

Objective To explore the correlation between endothelia cells activation and cytokines (ET-1, NO) levels in patients with pulmonary hypertension (PH), and to discuss their roles in the development of PH. Methods Twenty patients with simple ventricular septal defect (VSD) were chosen as controls, and 30 patients with PH were studied. Plasma levels of ET-1 and NO were measured by radioimmunoassay or colorimetric method. Before cardiopulmonary bypass was established, the specimens from right lung were fixed with formaldehyde solution, embedded with paraffin and stained by SP immunohistochemistry. Intercellular adhesion molecule-1 (ICAM-1) expression was measured through the determination of the light density with computer imaging technology. Results Compared with that of the patients with simple VSD, the light density of ICAM-1 and plasma level of ET-1 increased in patients with PH; but plasma level of NO decreased (P<0.05). Positive correlation was observed between ICAM-1 and ET-1/NO (P<0.05). Conclusion Endothelia cells activation and imbalance of ET-1/NO might play an important role in the development of PH.

ObjectiveTo investigate the effects of oxidized low density lipoprotein (oxLDL) on autophagy and its effect on Akt/mTOR/p70S6K signaling pathway in human umbilical vein endothelial cells (HUVECs).MethodsThe cultured HUVECs were divided into either an oxLDL or a control group, and treated with 100 μg/ml oxLDL and equal volume phosphate buffer solution respectively.The cells were collected after 6 h and 12 h.Transmission electron microscopy was used to observe the autophagosome.Real-time fluorescence quantitative polymerase chain reaction was used to detect expression levels of microtubule associated protein 1 light chain 3 (LC3) and p62 mRNA.Western blot was used to detect the expression levels of LC3, p62, P-Akt/Akt, P-mTOR/mTOR, and p-p70S6K/p70S6K.Results Compared with the control group, the number of intracellular autophagosome increased obviously (P<0.05), LC3 mRNA and protein expression levels increased significantly (all P<0.05), and p62 mRNA and protein expression levels decreased significantly (all P<0.05) in the oxLDL group.In addition, the phosphorylated protein expression levels of Akt, mTOR and p70S6K in the oxLDL group were significantly decreased than those in the control group (all P<0.01).However, total protein levels of Akt, mTOR, and p70S6K were not significantly different between the oxLDL group and the control group.Conclusion oxLDL may induce the autophagy of HUVECs via inhibiting the Akt/mTOR/p70S6K signaling pathway.

Objective To determine the change of tumor bed volume during whole breast irradiation by repeated computed tomography scanning and to analyze the dosimetric impact of boost-planning on different CT images. Methods From July 2008 to Jan 2009, sixteen patients with early-stage breast cancer underwent breast conservative surgery (BCS) were enrolled in the study. All patients received whole breast irradiation and tumor bed boost, no adjuvant chemotherapy was given. Two additional CT scans were acquired in addition to the planning CT ( CT1 ), one in the course of radiotherapy ( CT2 ) and the other before the boost (CT3). Tumor beds were contoured in all CT images. Three-dimensional conformal radiotherapy planning for tumor bed boost was done on CT1 and CT3 respectively. Results The mean tumor bed volume on CT1, CT2 and CT3 were 49.5 cm3, 25.6 cm3 and 22. 2 cm3 ( F = 5. 63, P = 0. 007 ),respectively. Further analysis found statistically significant difference between CT1 and CT2 ( q = 0. 03, P =0. 010), CT1 and CT3 ( q = 0. 01, P = 0. 004), but not between CT2 and CT3 ( q = 1.00, P = 0. 333 ). The average reduction of tumor bed volume from CT1 to CT3 was 43.4%. A reduction of 20% or above was found in 88% of the patients ( n = 14), 50% or above in 38% of the patients (n = 6). In the boost-planning, the volume of the ipsilateral breast receiving 100% prescribed dose (V100%) on CT1 and CT3 was 183.5 cm3 and 144. 5 cm3, respectively ( t = 3.06, P = 0. 008 ). Conclusions Volume of tumor bed is dynamically reduced in the course of whole breast irradiation after BCS, with more important reduction in the early weeks after the beginning of irradiation. A second CT scan before tumor bed boost is warranted.

Optical coherence tomography (OCT) is an optical diagnostic technique that provides non-contact, non-invasive tomographic imaging of microscopic structures of living ocular tissues.However, it requires the patient to be seated during the examination, which limits its use in infants and recumbent patients.Intraoperative OCT (iOCT) can be used in patients in the decubitus position to provide the surgeon with critical real-time information on anatomy and subtle lesions, improving the success and safety of the procedure.At present, the clinically applied iOCT types include handheld OCT, microscope-mounted OCT, microscope-integrated OCT and so on, among which integrated microscope-integrated OCT is the most widely used.iOCT is mainly used in a variety of fundus surgeries, retinal detachment reduction and proliferative diabetic retinopathy resection in retinal disease surgeries, and macular hole repair and anterior macular membrane stripping in macular surgery.During surgery, the use of iOCT can play a role in reducing surgical complications, detecting subclinical lesions, helping the surgeon make the most appropriate surgical decision, and predicting patient prognosis.This article reviewed the classifications of iOCT, as well as its advantages and disadvantages in the application of retinal detachment, diabetic retinopathy, macular epiretinal membrane, macular hole and other diseases to provide a reference for clinical practitioners.