Objective To summarize the experience of heart-lung transplantation.Methods Four patients with Eisenmenger’s syndrome underwent heart-lung homoplastic transplantation. All patients were complicated with severe pulmonary hypertension in New York Heart Association ( NYHA ) functional class IV. Cannulation for cardiopulmonary bypass consisted of a cannula in the high ascending aorta and separate vena caval cannulas. The heart-lung graft was moved into the chest, beginning with passage of the lung before the phrenic nerve pedicle. The bronchus was trimmed, leaving two cartilaginous rings proximal to the orifice of the upper lobe. The tracheal anastomosis was performed with a continuous 4-0 polypropylene suture, with the posterior portion continuously and anterior interrupted. The lungs were then ventilated (

Embryonic stem cell (ESC) is a kind of stem cell with self-renewal capability and developmental luripotency,which is at the early stage of embryonic development,and it is the original cell of various kinds of tissue and organ.Under certain conditions,ESCs can maintain an undifferentiated state,long-term surviving and infinite breeding state in vitro.The research of tberapeutic effect of ESCs in animal disease model,especially in ouse,has made great progress.On the basis of this research,researchers attempt to use ESCs for the clinical therapy of various diseases,and investigate the feasibility and security of this kind of therapy.Currently ESCs have been used in the therapy of diabetes mellitus,Parkinson's disease and cardiovascular injury.Even though many problems of technique and ethics should be done,we believe that ESC therapy will be a promising method and used in linical practice if we make clear the mechanism of ESC directional differentiation,establish an optimal culture system,and solve the problem of oncogenicity.

Objective To observe the repairing effects of myoblasts from mesenchymal stem cells induced by MyoD transfection on muscle injury, and to explore its mechanism. Methods One hundred and sixty male SCID mice were randomly assigned into 4 groups [normal group, control group with injury, implantation with mesenchymal stem cells (MSCs) group, and implantation with myoblasts group]. MSCs were transfected by pIRES2-EGFP-MyoD and differentiated into myoblasts. Myoblasts and MSCs were injected respectively into the muscular tissue injuried by cardiotoxin. The repairing effect in injuried muscles, which were injected with myoblasts and MSCs, was observed 1, 2, 4 and 6 weeks after the injection. Results The muscular tissue injury model was successfully reproduced. Both MSCs and myoblasts showed obvious repairing effects on the injured muscular tissue, and the strength of muscular tissue in myoblasts group was stronger than that in MSCs group. Western blot assay showed that MyoD expression in myoblasts group was much higher than that in both MSCs and control groups, the expressions of JNK1 and ERK2 were up-regulated in myoblasts group, and the p38 expression was down regulated significantly in the 1st week, but no significant difference was found when compared with those of the normal group at the 6th week. Conclusion Myoblasts transdifferentiated from MSCs induced by MyoD can repair the injuried muscular tissue effectively. JNK1, p38 and ERK2 play important roles in the repairing process.

Acute cerebral infarction is a common disease of the central nervous system, the key of the current treatment is to restore blood flow and save ischemic penumbra .The studies have shown that good collateral circulation can reduce the infarction area, improve prognosis.Thus, an accurate and complete evaluation of collateral circulation in the early stage of disease has an important sig -nificance.The development of modern imaging techniques provides important means for the assessment of collateral circulation estab -lishment in acute stroke .In this paper, techniques and methods of the imaging examination of collateral circulation establishment in a -cute cerebral infarction and methods are reviewed, aiming to provide the basis for choosing reasonable imaging modality .

Objective To discuss the important points of rescue strategies in saving patients and related administration to minimize the medical risk of county or district hospitals. Methods The analytic method to minimize the medical risk of district and county hospitals was from clinical practice and via induction,summary and reorganization. Results and Conclusions The reasonable and effective clinical medical operative process includes,timely necessary emergency initial examinations,immediately organizing group consultation after mastering the emergency rescue procedures in various critical situations,following the newest modern treatment guidelines or professional expert consensus,treating patients with correct motivation to maximize the therapeutic effect,carrying out treatment while the diagnosis confirmed,properly communicating between doctor and patient,timely recording the medical record,improving the diagnosis and treatment capacity in cases with critical and difficult diseases step by step,correcting the errors and mistakes,immediately and effectively proceeding to crisis public relations in time.

BACKGROUND: Quantitative pharmaco-electroencephalography (QPEEG) can reflect cerebral cortical function, which can be certainly affected by general anesthetics. Anesthesia depth has good correlation with the anesthetic dosage, so if we can find out the areas of brain and band of QPEEG which is relative to the anesthetic dosage, the band may be taken as the index to reflect the depth of anesthesia. OBJECTIVE: To observe the effects of propofol on the alpha2-band (α2- band) of QPEEG in rabbits. DESIGN: A randomized control animal experiment. SETTING: Jiangsu Provincial Key Laboratory of Anesthesiology, Xuzhou Medical College. MATERIALS: The experiment was carried out in the animal laboratory of Xuzhou Medical College from October 2004 to August 2005. Thirtysix healthy adult rabbits were randomly divided into propofol 2.5, 5 and 10 mg/kg groups with 12 rabbits in each, including 6 were used to observe the change of percentage of each band power of QPEEG, and the other 6 were used to observe the latency and duration for the disappearance of righting reflex in the rabbits. METHODS: The experiment was performed between 14:00-17:00 every day. Rabbits in the three groups were treated with intravenous injection of propofol of 2.5, 5 and 10 mg/kg respectively within 30 seconds. ① The conscious rabbits were fixed onto the platform in a prone osition, and the QPEEG was recorded with the method of power spectrum analysis before administration and at 20, 30, 40, 50, 60, 70, 80, 90, 100 and 110 s and 2, 5, 10, 15, 20 and 30 minutes after administration respectively. The sampling time for each time point was 5 s. ② The latency and duration for the disappearance of righting reflex in the rabbits were recorded. RESULTS: ll the 36 rabbits were involved in the analysis of esults. ① After the intravenous injection of propofol, the righting reflexes all disappeared within 1 minute. The greater the dosage, the shorter the latency and the longer the duration r=0.79, P ＜ 0.01). ② Compared with before administration, propofol of 2.5 mg/kg had no obvious influence on the percentage of α2-band power (P ＞ 0.05); The percentages of α2-band power in the brain areas were increased after administration in the propofol 5 mg/kg group (P ＜ 0.05); Except that there were no significant differences in the left and right parietal regions between the propofol 10 mg/kg group and the propofol 5 mg/kg group, the percentages of α2-band power in the other brain areas in the propofol 10 mg/kg group were decreased as compared with those before administration and those in the other two groups (P ＜ 0.05), and the changes above were more obvious in the frontal and temporal regions.CONCLUSION: The influence of propofol on the percentage of α2-band power of QPEEG is biphasic, it is suggested that α2-band would be an index to reflect the anesthesia depth of propofol.

Objective In recent years , multivariate pattern analysis ( MVPA) method was proposed and considered to be a promising tool for automated identification of various neuropsychiatric populations .Support vector machine ( SVM) is one of the most widely used methods of MVPA .Using SVM classifier for MVPA of amnestic mild cognitive impairment (aMCI) and normal control (NC) group, the present study aims to build an individual diagnostic model with significant discriminative power and investigate the gray matter abnor-malities of aMCI patients . Methods Fifty-one aMCI patients and 68 normal controls were scanned on the 3-Tesla magnetic resonance imaging (MRI) for high-resolution T1-weighted images.Gray matter volume map was calculated for each subject and used as features for subsequent discriminative analysis .We first applied feature selection to remove redundant information and reduce feature dimension , and then trained an SVM classifier . Leave-one-out cross validation ( LOOCV) was used to estimate the performance of the classifier , and finally the most discriminative features were identified . Results The proposed classifier achieved a classification accuracy of 83.19%with a sensitivity of 76.47%and a specificity of 88.24%.In ad-dition, the area under the receiver operating characteristic (ROC) curve was 0.8368.Further analysis revealed that the most discrimi-native features for classification included bilateral parahippocampal gyri , bilateral hippocampi , bilateral amygdala , bilateral thalamus , right cingulate , right precuneus , left caudate , left superior temporal gyrus , left middle temporal gyrus , left insula and left orbitofrontal cortex. Conclusion The proposed classification model has achieved significant accuracy for aMCI prediction , and it also displayed the whole brain gray matter atrophy pattern in aMCI patients .It suggests that the proposed method may have important implications for early clinical diagnosis of aMCI patients .

Objective To analyze the effect of autologous bone marrow stem cells transplantation in treatment of patients with decompensated cirrhosis. Methodls Seventy-eight patients (aged from 26 to 67) with decompensated cirrhosis, including 56 with hepatitis B, 21 with alcoholic cirrhosis and 1 with schistosomial cirrhosis, were included. Bone marrow was aspirated from poster superior spine. After isolation and purification, the stem cells were transplanted into liver via hepatic artery. The liver function, laboratory parameters and Child-Tureotte-Pugh scores were evaluated in 2,4 and 8 weeks after transplantation. Results At the 4th week after transplantation, the level of albumin was increased obviously from (32.9±5.58) g/L to (38.32±6.45) g/L,whereas the alanine aminotransferase was decreased from (96.92±83.91) U/L to (73.48±18.46)U/L. It was revealed that the prothrombin time was decreased from (16.66±3.91) s to (15.52±3.35) s and fibronegen increased from (2. 22 ± 0. 88) g/L to (2. 58±0. 88) g/L. After transplantation, appetite was improved in 72 cases (92.3%), ascites was decreased in 70 cases (89.7%) and abdomen distention was ameliorated in 68 cases (87.2%). There was no complications related to the transplantation. Conclusion Transplantation of autologous bone marrow stem cells is a safe and effective method in treatment of patients with decompensated cirrhosis.

Objective:To evaluate the immunogenicity of an experimental SARS-CoV inactivated vaccine.Methods:The virus suspension of F69 strain was inactivated with 0.4% formaldehyde and purified,then used as the immune antigen combined with Freund′s adjuvant.Eight adult New Zealand rabbits were immunized 4 times with this vaccine.12 sets of rabbit serum were sampled from the third day to 74th day after first immunization.Titers of specific IgG antibody and neutralizing antibody were determined by indirect ELISA and micro-cytopathic effect neutralizing test.Results:Rapid and potent humoral immune responses were induced by F69 inactivated vaccine in all eight immunized rabbits.Both specific IgG antibody and neutralizing antibody all peaked just with 2 vaccinations,with the maximum titer of 1∶81 920 and 1∶20 480 respectively about 6 weeks after first immunization.Across neutralizing reaction existed between F69 and Z2-Y3 strains.Conclusion:F69 inactivated vaccine owns strong immunogenicity.Similar antigenic epitopes exist between the F69 strain and Z2-Y3 strain,which ensured the cross neutralizing reaction.

Objective To investigate the recent efficacy and safety of autologous bone marrow stem cells transplantation in treatment of early spinal cord injury. Methods 51 cases of early spinal cord injury admitted to Liaocheng People Hospital from 2007.11 to 2009.8 were enrolled in this study. In transplantation group, 24 patients were treated by subarachnoid space injection with autologous bone marrow stem cell transplantation. The patients who were not transplanted in the same period of hospitalization were selected as control group. Motor and sensory function ( AISA score) was assessed at 1, 3, 6 months before and after transplantation in two groups patients. And blood routine, clotting mechanisms, biochemical items andtunor markers were determined in followed up. Results After one month of transplantation, two groups ofpatients had recovered in motor and sensory function to some degree. After three months of transplantation,there was significant different between transplantation group and control group in sensory function recovery (P < 0. 05 ). After 6 months of transplantation, there were significant different between transplant group and control group in motor and sensory function recovery (P<0.05). Blood examination results did not show markedly abnormal in followed -up patientsConclusion The safety and recent effect of autologous bone marrow stem cells transplantation in treatment of early spinal cord injury were satisfied, but the long - term effect was still unclear.