Objective To explore the clinical features and urgent treatment strategies of open stabbing and penetrating wound of the heart. Methods In recent five years, 22 cases of cardiac trauma patients were sent to our emergency department, among them 19 sustained penetrating wounds produced by sharp instruments, 3 with perforating wounds, produced by firearm in 2 and sharp instrument in one. Emergent thoracotomy was performed in all the patients. The injury involved right auricle in 4, left auricle in 1, right ventricle in 11, left ventricle in 3, and perforating wounds of both right and left ventricles in 3 patients. Results Among them 19 survived, and their cardiac and pulmonary recovered 2 weeks after the operation. Three patients with injury of the great vessel died, one of them died 8 hour after the operation. Conclusion When the patients who presented open wounds on the anterior or posterior chests, showing a low or undetectable blood pressure, which could not raised even with fluid resuscitation with two venous lines or in some of them displaying signs of Beck's triad, open cardiac injury should be seriously suspected, and emergent thoracotomy should be taken in order to rescue the patients.

Objective:To study the expression of suppressor of cytokine signaling 1(SOCS1) and cellular myelocytomatosis oncogene(c-myc)in hepatocellular carcinoma(HCC),and to inves-tigate the relation between the expression of SOCS1 and c-myc in HCC.Methods:The expressions of SOCS1 and c-myc protein of 41 HCC tissues and surrounding tissues,as well as the tissues of 11 normal cases,were detected by immunohistochemical(IHC)staining using SP method.The expression of SOCS1 mRNA was detected by RT-PCR.And the clinical and pathological data were analysed.Results:Compared with the para-carcinoma and normal liver tissue,the levels of SOCS1 and SOCS1 mRNA in HCC tissues were significantly lower(P

Purpose:To study the expression of MT1-MMP ,EMMPRIN and P-gp in gastric carcinoma and the relation of invasion, metastasis with drug resistance in gastric carcinoma. Methods:Detected membrane-type-1 matrix metalloproteinase (MT1-MMP), extra-cellular matrix metalloproteinase inducer (EMMPRIN), P-glycoprotein (P-gp) in gastric carcinoma by immunohistochemical method. Results:Among 40 cases of gastric carcinoma, there were 15 cases (37.5%) MT1-MMP-positive, 26 cases (65%) EMMPRIN-positive, 23 cases (57.5%) P-gp-positive respectively. The over-expression of MT1-MMP, EMMPRIN, P-gp was associated with invasive depth and lymph node matasteses of tumor cells(P

Objective To study the clinical features of spontaneous rupture of the right cardiac atrium. Methods Two cases of spontaneous rupture of right cardiac atrium were reported, and related literature was reviewed. Results Spontaneous rupture of the right cardiac atrium which was a rare disease, presented symptoms including stifling sensation in the chest, chest pain and symptoms of cardiac tamponade. The diagnosis should be differentiated with by ultrasonic examination and CT from cardiac infarction, cardiac rupture caused by external injury and dissecting aneurysm of aorta. Conclusion Spontaneous rupture of right cardiac atrium is rare disease, and an early diagnosis and prompt operation are necessary.

Objective To study the relationship between hyperhomocysteinemia and type 2 diabetes patients with cerebral infarction and its influencing factors.Methods Serum homocysteine levels were measured by high performance liquid chromatography (HPLC) in type 2 diabetes patients with cerebral infarction (DS group), type 2 diabetes patients without complications (DNC group) and normal control subjects. Plasma folate and VitB 12 concentrations were detected by radioimmune assay.Results The levels of homocysteine in DS group and DNC group were significantly higher than in normal control group (all P

Objective To study perioperative changes in serum levels of TNF-?, IL-6 and IL-10 in orthotopic liver transplantation without veno-venous bypass. Methods Sixteen patients with terminal liver disease underwent orthotopic liver transplantation under general anesthesia. Samples from arterial blood were obtained at beginning of surgery, before the anhepatic phase, 5min before recirculation, 15min and 60min after recirculation, 4h and 24h after operation, respectively. Serum levels of TNF-?, IL-6 and IL-10 were measured by ELISA. Results TNF-? and IL-6 concentrations were kept at a low level before operation, while IL-10 was not detected. The concentrations of IL-6 and IL-10 rose during the anhepatic phase (P

OBJECTIVE: To optimize the preparation technology of poly(lactide-co-glycolide) (PLGA) microspheres loaded with ropivacaine (ROP-PLGA-MS) and study their powder particle characteristics and in vitro release characteristics. METHODS: ROP-PLGA-MS was prepared with PLGA as carriers using the water-in-oil-in-water(W/O/W) emulsion solvent evaporation method. The micromeritic characteristics of ROP-PLGA-MS,such as the particle size,loading and entrapment efficiency were taken as indexes for evaluation,and the preparation technology was optimized by orthogonal design. Its dissolution characteristics in vitro were studied. RESULTS: The prepared microspheres were spherical with smooth surfaces,with an average particle size of (2.525?0.047) ?m and over 80% falling in the range of 1.8～5.0 ?m. The encapsulation efficiency was (58.05?1.169)% and the drug loading efficiency was (6.067 ?0.312)%. The in vitro release curves of ropivacaine microspheres could be fitted with Higuchi equation. The accumulated release percentage of which was 82 % in 192 h,and t1/2=60.16 h. CONCLUSION: ROP-PLGA-MS has obvious sustained release.

Objective To investigate changes of oxidative stress in the hearts and their roles in diabetic cardiomyopathy of rats.Methods Thirty six rats with diabetic cardiomyopathy were induced by streptozocin(STZ),and were randomly divided into three groups:(1) normal control (NC) group,normal control rats; (2) Diabetes maintain (DM) group,diabetic rats received protamine zinc insulin (PZI) 2 ～4 U/2 days; and (3) Diabetes treatment (DT) group,diabetic rats received PZI 9 ～ 12 U/kg body weigh/day.After 12 weeks,rats were killed,and the parameters including blood glucose,glycated hemoglobin a1c (HbA1c),total cholesterol (TC),and triglyceride (TG) were measured.Maleic dialdehyde (MDA),the total antioxidant capacity of the hearts,and activities of antioxidant enzymes in hearts including total superoxide dismutase (TSOD),catalase (CAT),and glutathione peroxidase (GSH-Px) were measured by chromatometry.The pathologic changes of heart tissues were studied by hematoxylin eosin (HE),periodic acid Schiff (PAS),and nitrotyrosine (NT) staining.Results After 12 weeks,parameters including blood glucose,HbA1c,TC,and TG were increased significantly in DM group relative to NC group or DT group.The level of heart MDA was elevated obviously in the DM group [NC group (7.82 ±0.62) nmol/mgprot,DM group (12.81 ± 1.35) nmol/mgprot,and DT group (8.20 ±0.85) nmol/mgprot].The total antioxidant capacity and activities of TSOD [(235.09 ± 14.94) U/mgprot],GSH-Px [(56.59 ± 4.96) U] were decreased significantly in the DM group.The level of CAT [(13.84 ± 2.88) U/mgprot] was increased obviously in the DM group.The cardial myocyte hypertrophy,myocyte steatosis,and PAS positive material could be found in the hearts of rats in DM group with HE and PAS staining.The expression of NT was much stronger in DM group than NC or DT groups.NT was less expressed in DT group,and was almost not expressed in the NC group.Conclusions Oxidative stress could be caused by diabetes in diaetic hearts and might play an important role in the etiology of diabetic cardiomyopathy.

Objective:To evaluate and compare the effciency and safety of Cyberwand dual probe lithotriptor and Swiss lithoclast master in percutaneous nephrolithotomy for renal staghorn calculi.
Methods:A total of 138 patients with renal staghorn calculi were divided randomly into a Cyberwand dual probe lithotripter group (Group A, n=71) and a Swiss lithoclast master group(Group B, n=67). hTe data for operative time, blood loss volume, one-stage calculus clearance rate, hospitalization time, cost of hospitalization and complication in the two groups were collected and compared.
Results: The renal access was established successfully and the one-stage percutaneous nephrolithotomy (PCNL) was performed in the 2 groups. There was no significant difference in the size of stones, the age of patients and the complications between the 2 groups before the operations. Intraoperative gravel time in the Group A was signiifcantly shorter than that in the Group B (77.14±21.39 vs 84.25±20.62, P=0.049). There was no significant difference in the one-staged stone clearance rate, blood loss volume in the operation between the 2 groups. hTe one-staged stone clearance rate in the 2 groups were 67.6%(48/71) and 70.1%(47/67) respectively, with no signiifcant difference (P=0.854).
Conclusion:Two lithotrities were safe and effcient for renal staghorn calculi. But comparing with Swiss lithoclast master, Cyberwand dual probe lithotriptor is more effcient and convenient.

Objective To quantitatively analyze the histological and MR images of repaired tissue (RT) following microfracture for knee joint osteochondritis dissecans (OCD) in rabbit models at different time points,make comparisons with the RT performances of joint debribement,explore the efficiency of the microfracture treatment for OCD.Methods Twenty-seven New Zealand rabbits were randomly assigned into 3 groups (sacrificed at the end of 3,5 and 7 weeks post-operation respectively),with 9 in each group.For each rabbit,one knee joint was made into an OCD model.In each group,6 were for microfracture treatment,and the other 3 were for joint debridement as control.MR scan,which mainly included sequences of 3D double echo steady state sequence (3D-DESS) and T2-mapping,was taken at 3,5 and 7 weeks postoperation.The thickness index and T2 value index of RT were calculated and T2-mapping of repaired region was drafted.Then the operation sites were removed to make histological sections of HE and Masson staining.The modified O' Driscoll score system was employed to make semi-quantitative evaluation for the histological performance of RT.Comparisons were made with respect to MR and histological findings between two treatments at each time point using unpaired Student t test.Effects of two treatments were evaluated longitudinally by comparing the results of three time points using one-way ANOVA.Results The post-operation thickness indexes of two groups increased gradually (F =33.940,28.841,P ＜ 0.05),T2 value indexes decreased (F =80.183,206.206,P ＜ 0.05),and O'driscoll scores increased gradually (F =29.867,17.167,P ＜ 0.05).At each time point,the thickness index of microfracture was higher than that of debridement group(3-week:0.743 ±0.048 vs 0.624 ±0.013,t =4.077 ;5-week:0.813 ±0.031 vs 0.734 ±0.015,t =4.107 ; 7-week: 0.972 ± 0.064 vs 0.777 ± 0.039,t =4.782 ; P ＜ 0.05),and the defects of microfracture in 7-week group were almost fully recovered while the defects of the debridement in 7-week group were not.The T2 value index of microfracture group was lower than that of debridement group at 3-week point(1.338 ±0.043 vs 1.510 ± 0.009,t =6.583,P ＜ 0.05),but it was higher than that of debridement group at 5-week and 7-week points (5-week: 1.284 ± 0.097 vs 1.116 ± 0.068,t =2.663 ; 7-week: 0.916 ± 0.036 vs 0.843 ± 0.016,t =3.283 ; P ＜ 0.05).The O'Driscoll score of microfracture group was higher than that of joint debridement at every time point(3-week:7.167 ±0.753 vs 4.667 ±0.577,t =5.000;5-week: 9.833 ± 1.169 vs 7.667 ± 0.577,t =2.960 ; 7-week: 11.167 ± 0.753 vs 8.333 ± 1.155,t =4.520 ; P ＜ 0.05).For microfracture group,the RT was mainly repaired by fibrocartilage and got matured gradually with more production of well-distributed collagen fibrils ; while for joint debridement group,the RT was mainly repaired by fibrous and scar tissue.Conclusions The post-operation repairing thickness and tissue composition of microfracture for OCD are superior to that of joint debridement.MR 3D-DESS and T2-mapping can show the thickness and tissue composition of the RT after OCD treatments,provide effective evaluation of repairing conditions,and they are of great importance on the OCD post-op follow-up.