Objective To summary the experience of management for orthotopic homologous heart transplantation,heart-lung co-transplantation and to discuss the postoperative treatment of short-term complications.Methods Orthotopic homologous heart transplantation and heart-lung co- transplantation on 9 cases were performed from May 2004 to February 2006.The patients were traced closely and all complications were treated in time.Results During hospital stay,hypertension oc- curred in one case,right heart insufficiency in one case,infection of mycetes and cytomegalovirus in 2 cases after the heart transplantation,and in the patient undergoing heart-lung co-transplantation,renal inadequacy,bronchial anastomosis stenosis and fungus infection occurred.All patients obtained symp- tomatic relief before discharge.Conclusion Proper perioperative management,immunosuppressive therapy and management of postoperative complications could reduce mortality and obtain satisfactory therapeutic effect in the near future.

Objective To discuss the operative technical details in reducing complications after thyroid diseases reoperation, especially how to choose operative method and preserve laryngeal recurrent nerve and parathyroid gland. Methods The study protocols of 183 patients undergoing reoperation for thyroid disease from Jan. 2000 to Mar. 2009 were reviewed. There were 115 cases of benign and 68 cases of malignant thyroid diseases to observe the postoperative complications. Results The rates of temporary and permanent laryngeal recurrent nerve injury were 4.92% (9/183) and 1.64% (3/183), respectively. The rates of temporary and permanent hypocalcemia were 4.37% (8/183) and 0.55% (1/183), respectively. The rate of postoperative internal hemorrhage was 0.55%(1/183). Conclusions The thyroid reoperation was more difficult and can seduced a high rate surgical complication. The thyroid reoperation can be successfully performed if the operators could pay attention to the operative skill.

Objective To construct an expression system to produce the virus-like particles containing a part of the sequence of PSA mRNA, which are ribonuclease-resistant due to the encapsulation of the mRNA by bacteriophage MS2 coat proteins. Methods The PCR products of PSA cDNA fragments were cloned to TA vector pBS-T, then the targeted segments could be obtained when the pBS-T-PSA were digested by restriction endonuclease Hind Ⅲ and cloned to prokaryocytic expression vector pNCCL1. The recombinant plasmids named PNCCL1-PSA were transfected into E. Coli BL21-DE3 and induced to express with IPTG. Results The recombinant plasmids were successfully constructed. The bacteriophage MS2 coat protein which expressed in BL21 can self- assemble to form ribonuclease resistant virus-like particles and the PSA mRNA was encapsulated into virus-like particles. Conclusions The virus-like particle containing PSA mRNA can be expressed in prokaryocyte and it can be used as standard and control in detecting PSA mRNA. It provides a new, stable and ribonuclease-resistant RNA standard in RNA detection.

OBJECTIVETo investigate diagnosis and therapeutic effects of knee joint synovial chondromatosis with arthroscopic.

METHODSFrom March 1995 to July 2011, 28 patients with knee joint synovial chondromatosis were treated. Among them, 18 males and 10 females ranging age from 25 to 81 (mean 55.2) years,the course of disease ranged from 0.5 to 15 (mean 5.6) years. Clinical manifestation mainly included pain, swell and functional limitation of knee joint. Knee open surgery (17 cases) and laparoscopic surgery (10 cases) were respectively used. Clinical symptom,image data,pathological manifestation and effects under arthroscopy were observed, Lysholm scoring was used to evaluate effects.

RESULTSAll patients were followed up except one lost, the duration ranging from 6 to 24 months. Lysholm score in knee open surgery was increased from (41.89 +/- 6.81) preoperatively to (67.73 +/- 7.62) postoperatively;while in laparoscopic surgery it was increased from (40.78 +/- 7.54) preoperatively to (77.46 +/- 8.43) postoperatively.

CONCLUSIONArthroscopic surgery, which has no risk of rupture of incision, nonunion, earlier to exercise, is a good method to diagnosis and treat knee joint synovial chondromatosis.

Adult ; Aged ; Aged, 80 and over ; Chondromatosis, Synovial ; diagnosis ; surgery ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; surgery ; Laparoscopy ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo investigate the efficiency and safety of different regimens by intravesical instillation of epirubicin, a derivative of adriamycin, for the prevention of primary superficial bladder carcinoma from recurrence.

METHODSNinety patients supplemented with intravesical epirubicin instillation after operation were randomly divided into three groups: Group A--80 mg in one dose; Group B--repeated epirubicin 40 mg q wk x 4-8 sessions followed by q month to the end of the second year; or Group C--50 mg q month to the same duration. All patients were followed up for two years by observing the recurrence rates and side effects.

RESULTSThe recurrence rate of groups A, B and C at one year was 16.7%, 13.3% and 16.7%, respectively, without any significant difference observed. However, it was 50.0%, 36.7% and 36.7% at two years, at which time the recurrence rate of group A was significantly higher than those of groups B and C. The side effects rate was 23.3%, 40.0% and 33.3% for groups A, B and C, respectively. The more instillations the patients had, the more severe side effects were.

CONCLUSIONEarly postoperative single high dose intravesical instillation of epirubicin combined with repeated lower doses of the same drug every month may be an efficient and safe regimen to prevent the primary superficial bladder carcinoma from recurrence.

Administration, Intravesical ; Adult ; Aged ; Antibiotics, Antineoplastic ; administration & dosage ; adverse effects ; Combined Modality Therapy ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; prevention & control ; Postoperative Period ; Prospective Studies ; Urinary Bladder Neoplasms ; prevention & control ; surgery

ObjectiveTo explore the inductive action of docosapentenoic acid(DPA) on neurite outgrowth in PC12 cells in vitro.MethodsNeurite outgrowth in PC12 cells was examined after the treatment with different concentration of DPA using Motic Zamges Plus software mapping cell image system.Western blot was performed to detect the expression of β Ⅲ-tubulin regulated protein kinase,a neuronal marker as well as ERK and protein kinase B (Akt) phosphorylation.ResultsPC12 cell neurite formation rate was increased in a concentration dependent manner in the induction of DPA,increased by 2.4% (DPA 10 μg/ml,P>0.05),18.6% (DPA 30 μg/ml,P<0.05) and 25.0% (DPA 50 μg/ml,P<0.05) compared with that in the control group.DPA promoted the expression of β Ⅲ-tubulin (P<0.05) and the phosphorylation level of ERK and Akt (P<0.05,P<0.01).ConclusionDPA promotes PC12 cell neurites growth and its mechanism may be related to the activation of ERK and Akt signaling pathways.

Objective To review the safety and efficacy of upper-pole access percutaneous nephrolithotomy (PCNL). Methods From May 2008 to May 2010,237 cases ( 135 males and 102 females with mean age of 42 yrs) of renal or proximal ureteral calculi treated with upper-pole access PCNL were reviewed.The indications included calculus larger than 1.5 cm or impacted proximal ureteral calculi in 94 cases,calculus≥2 cm or impacted renal pelvic calculi in 26 cases,staghorn or multiple calculi in 68 cases,complex lower calyx calculi in 13 cases,upper calyx calculi not amenable to ESWL or URS in 12 cases,calculi within upper calyx diverticulum in 3 cases,combined UPJ obstruction or upper ureteral stenosis in 8 cases,morbidly obese patients in 3 cases,calculi within horseshoe kidneys in 6 cases,calculi within transplanted kidneys or ureters in 4 cases.Of the 237 cases,175 tracts (73.8％) were above the 12th rib,46were above the 11th rib,12 were below the 12th rib,4 were in the lower abdomen for renal transplant patients. Results The overall stone clearance rate with upper-pole access PCNL monotherapy was 74.3％.Additional punctures were required in 55 cases and combined ESWL in 6 cases.Total stone clearance rate at 3 months after operation was 88.2％.16 patients (6.8％) had a pleural injury.Thoracentesis was required in 8 patients,closed thoracic drainage in 5 patients,conservative treatment in 3 patients.After nephrostomy tube removed,pleural irritation symptom appeared in 12 cases (5.1％) who required symptomatic treatment.No patient had injury to the lung or other viscera.Significant bleeding requiring blood transfusion was olserved in 5 patients,while selective renal arterial embolization was required in 2 cases. Conclusions Upper-pole access offers optimal visibility,convenience for the movement of rigid nephroscope and high stone-free rate.It should be attempted in selected cages of upper ureteral calculi and complex renal calculi.

Objective To explore the risk factors of antidepressant treatment emergent suicidal ideas or attempted suicide among patients with bipolar depression. Methods Out of 623 patients with bipolar disorder visiting between June 2006 and June 2009,68 who was initially diagnosed as unipolar disorder and treated with antidepressants were retrospectively surveyed. Suicide and activation symptoms during the process of antidepressant treatment were estimated based on the cases record and semi-structural interviews. Unconditional bivariate logistic regression was conducted to analyze the potential risk factors. Results Of 68 patients,7 ( 10. 3% ) experienced antidepressant treatment emergent suicidal ideas and 4 ( 5.9% ) attempted suicide after 2 to 63 ( 17.45 ± 5.90 )days following the treatment. The antidepressant treatment emergent suicidal ideas or attempted suicide were related to the suicidal level before treatment (P= 0. 012, OR = 2. 072 ) and the combined use of benzodiazepine (P =0. 043, OR = 0.236). Clinical subtypes, gender, age, symptoms feature, types of antidepressant and antidepressanttreatment emergent activation symptoms had little impact on the antidepressant treatment emergent suicidal ideas orattempted suicide (P ＞ 0.05 ). Conclusion The antidepressant treatment emergent suicidal ideas or attempted suicide among patients with bipolar depression are positively related to the suicidal level before treatment while negatively associated with the combined use of benzodiazepine.

Objective To explore a method of using a computer system for multi-media cases study in radiation oncology clinical work,in order to replace the traditional use of film images and paper.Methods We use a dedicated networked computer's Windows XP's Remote Desktop feature to remote access an Eclipse TPS and the radiation therapy information management system.Then we can online read the patient' s information of CT images,target volumes,treatment plans,plan application forms and electronic medical records,and use a projector to project it on the screen.Results There has been half a year since we successfully set up a radiation therapy case study multi-media system in the department.It's convenient and effective to achieve the department conducted a collective case discussion.Conclusions The equipment required is simple,and it's a safe and reliable technology,greatly improving the clinical efficiency and quality of medical care.

Objective To explore the value of echo-tracking technique in the detecting the ipsilateral external iliac artery elasticity after gunshot wound in pig limbs.Methods Two-dimensional ultrasound imagings and elasticity parameters of external iliac artery of fifteen pig limbs were obtained respectively,and the results were compared with pre-injury groups.The animals were sacrificed after ultrasonography.Pathological examinations of adjacent external iliac artery of injured pig limbs were analyzed.Results Two-dimensional ultrasound imagings of external iliac arteries had no significant changes post-injury.The changes of elasticity parameters were significiant differences in the injured group comparing with the pre-injured group (P ＜0.05),including the increased stiffness parameter(β),pressure-strain elasticity modulus (Ep)and the decreased arterial compliance(AC).Pathological result showed that the internal elastic lamina of artery detected were flat,endothelial cells came off discontinuously and structure of them were undefined.Conclusions Echo-tracking technique can find the elastic changes of adjacent artery indirect injured by gunshot wound sensitively and which can suggest the occurrence of vascular indirect injury.