Objective To explore the improvement of traditional incision in thoracotomy and the application of subaxillary vertical small incision in lung operations. Methods We carried out a retrospective analysis on documents of 680 cases of subaxillary vertical small incision pneumonectomy conducted in this hospital between December 1996 and June 2003. Results The length of incision was 8~13 cm (mean, 11 2 cm). The time for thoracotomy was 4 5~10 min (mean, 6 min) and the operation time was 50~ 170 min (mean, 135 min). The intraoperative blood loss was 100~1200 ml (mean, 350 ml), the postoperative drainage volume was 120~800 ml (mean, 300 ml), and the perioperative blood transfusion, 0~1400 ml (mean, 300 ml). Postoperative pain classification results revealed that 585 cases of grade 1, 60 cases of grade 2 and 35 cases of grade 3 severity were observed. The postoperative hospital stay was 10~21 days (mean, 14 days). No surgical death occurred. Conclusions Subaxillary vertical small incision can be simply made. It offers minimal invasion, less blood loss, mild postoperative pain, quick recovery and good cosmetic results, being a viable option in most operations of pneumonectomy.

Recently,there was great development in the field of small bowel transplantation,which has been become effective in clinical research.However,similarly with the transplantations of heart,lung,liver and kidney,chronic rejection was becoming an important factor for the long-term survivals of grafts.With the deepening comprehensions towards the mechanism of chronic rejection,more methods and therapies were tried and tested.

Drug Resistance, Viral ; genetics ; Hepatitis B virus ; drug effects ; genetics ; Mutation

Tumor metastasis is a primary cause of leading to death of tumor patients,and difficult to control.The relationship between primary tumor(PT)and metastasis tumor(MT)is extremely complicated. Considerable animal experiments and clinical data confirm that treatment of PT encourages the growth of MT, but the mechanism is not still fully clear.Some studies show that the density depression of antiangiogenesis factor and immune escape of tumor cell are main reasons for MT accelerated growth.This article reviews the animal experiment,clinical observation and occurrence mechanism of primary tumor treatment promoting tu- mor metastasis.

Objective To analyse reperfusion arrhythmias in AMI patients treated by direct PCI. To investigate prevention and treatments so as to elevate operation achievement ratio.Methods One hundred and seventy six AMI patients underwent direct PCI; of the 176 patients, 56 presented reperfusion arrhythmias. Observations were made in the context of the different arrhythmias, relation between the time onset of the arrhythmias after reperfusion, relation of infarct size number of the involved vessels and the infarct size to the arrhythmias. Results PCI performed with six hours after AMI showed much higher incidence of arrhythmias than PCI performed six to twenty four hours after AMI (P0.05).Conclusions Reperfusion arrhythmias were commonly seen in AMI patients treated by direct PCI. Early prevention and detection with appropriate treatment is the key to elevate survival rate leading to a better prognosis.

Objective To discuss the diagnosis and surgical management of pulmonary sclerosing hemangioma(PSH).Methods Clinical records of 33 cases of PSH(34 lesions) in this hospital from 1987 to 2002 were reviewed.There were 6 male cases and 27 female cases,with a mean age of 41.3 years(range,24~57 years).Twenty-three cases had an initial symptom of bloody sputum,while 10 cases were disclosed by physical examinations.Image findings revealed solitary mass of the lung in all the cases,in 5 of which a "crescent sign" was presented.Results Preoperatively,28 cases were diagnosed as having pulmonary benign tumors(including 5 cases of suspected sclerosing hemangioma),1 case was clarified as having PSH by percutaneous needle aspiration cytology,and 4 cases were misdiagnosed as having lung cancer. All the patients received surgical treatment,including 21 cases of unilateral pulmonary lobectomy,1 case of bilateral lobectomy,5 cases of segmentectomy,4 cases of wedge resection(including 1 case of bilateral thoracoscopic wedge resection),and 2 cases of tumor excision.The operation time was 45~210 min(mean,90 min),and the blood loss was 100~600 ml(mean,230 ml).No peri-operative deaths were encountered.Follow-up surveys in 33 cases for(3~)10 years(mean,5.5 years) found no recurrence.Conclusions In middle-aged women,if the sign of bloody sputum develops,and image findings indicate the solitary mass of the lung,especially with a "crescent sign",a diagnosis of PSH is possible.Percutaneous needle aspiration cytology is helpful to make a confirmative diagnosis in some patients.It is advisable to manage the disease surgically.

Objective To investigate the effect of Intestinal Function-recovering Decoction on the bacteria and endotoxin translocation and the content of malondialdehyde(MDA)and superoxide dismutase(SOD)in serum of rats with multiple organ dysfunction syndrome(MODS).Methods Fifty-seven SD rats were divided into four groups randomly:control group,MODS group,decoction group and ampicillin group.We detected the content of endotoxin in the peripheral vein,portal vein and ileum.Bacterial translocation,change of ileum mucous membrane in pathomorphology and the contents of MDA,SOD,ALT,AST,Cr and BUN in serum in each group were also examined.Results The hepatic and renal function and ileum mucous membranes were significantly damaged in MODS group,decoction group and ampicillin group.Compared with those in MODS group,serum MDA,ALT,AST,Cr,BUN and endotoxin in the peripheral vein,portal vein and ileum in decoction group were significantly lower(P0.01).It exhibited a negative correlation between serum MDA and SOD in MODS group and ampicillin group(P

Objective:To investigate the preparation of paclitaxel-loaded nanoparticles targeting liver cancer stem cells and their effects on liver cancer HepG2 cells (CD133 positive subset accounting for 8%) and Huh-7 cells (CD133 positive subset accounting for 65%).Methods:Poly (lactic-co-glycolic acid)-loaded paclitaxel nanoparticles were prepared by using emulsification-solvent evaporation method. Paclitaxel-loaded nanoparticles decorated with anti-CD133 antibody, called targeted nanoparticles, were prepared by using 1- (3-dimethylaminopropyl)-3-ethylcarbodiimide/N-hydroxysuccinimide (EDC/NHS) cross-linking method. The manifestations and physicochemical characteristics of the nanoparticles including encapsulation efficiency, loading efficiency, particle size distribution, morphology and release in vitro were studied. Liver cancer Huh-7 and HepG2 cells accompanying with paclitaxel-loaded nanoparticles or targeted nanoparticles were cocultured. The uptake and accumulation of nanoparticles by liver cancer cells were analyzed by using flow cytometry, and positive cell proportion of CD133 was also detected. Cell survival was analyzed by using plate clonogenesis assay.Results:Scan electromicroscopy result showed particle size of targeted nanoparticles was (429.26±41.53) nm with zeta potential of -11.2 mV; targeted nanoparticles were possessed with spherical morphology and higher encapsulation efficiency [(87.53±5.90) %]. Flow cytometry showed that in Huh-7 cells at 37℃, the fluorescence intensity of targeted nanoparticles group (13 397±720) was higher than that of paclitaxel-loaded nanoparticles group (6 898±604), and the difference was statistically significant ( P < 0.05); there was no statistically difference in the fluorescence intensity of HepG2 cells in paclitaxel-loaded nanoparticles group and targeted nanoparticles group at 37 ℃ (7 899±343 vs. 8 432±516, P>0.05). CD133 positive cell proportion of Huh-7 cells in targeted nanoparticles group [(15.7±2.6)%] was lower than that in paclitaxel-loaded nanoparticles group [(54.9±7.4)%], and the difference was statistically significant ( t = 7.31, P = 0.008); there was no statistical difference of HepG2 cells between the two goups ( P > 0.05). Plate clonogenesis assay showed that the cell survival rate of Huh-7 cells in targeted nanoparticles group was lower than that in paclitaxel-loaded nanoparticles group at different time points, and the difference was statistically significant ( F = 5.56, P = 0.009); but there was no statistically significant difference in HepG2 cell survival rate between the two groups ( F = 1. 19, P = 0.142). Conclusion:Prepared nanoparticles targeting liver cancer stem cells have a good inhibitory effect on liver cancer Huh-7 cells.

BACKGROUND: Heme oxygenase-1 (HO-1) plays an important role on preventing tissues and organs from oxidant stress injury, which remains currently one of the most active areas of investigation. OBJECTIVE: To study HO-1 over-expression on the survival and fiver function of rats after reduced-size liver transplantation by constructing recombinant adenovims Ad5-HO-1.DESIGN, TIME AND SETTING: Randomized controlled animal study was performed in the Institute of Pediatrics, Children Hospital Affiliated to Chongqing Medical University from September 2003 to March 2005. MATERIALS: Seventy-four SD rats were used to establish in situ reduced-sized liver transplantation models. METHODS: Recombinant adenoviral vector encoding Ha-1 gene (AdS-HO-1) was generatred by molecular biology method, wluch was administered to donors via voln at 48 hours before transplantation. All rats were randomly divided into control group(n=12),saline group(n=12), cobalt protoporphyrin (CoPP)group(n=13),Ad5-HO-1 group(n=13),Ad5-green fluorescent protein(GFP)group(n=12),and Ad5-HO-1+zinc protoporphyrin (ZnPP)group (n=12).Livers of donor wefe harvested and stored for 24 hours at 4℃ in HTK solution. Before it is implantedinto recipient. MA IN OUTCOME MEASURES: Survival rate and liver function; portal vein blood flow monitored 2 hours after transplantation by Color Doppler How Imaging; pathological changes of transplanted liver tissue observed by HE staining;HO-1 activity, tumor necrosis factor-alpha(TNF-α),Bcl-2 and Bax expression detected by immunohistoehemical staining; changes of HO-1,TNF-α,bcl-2 and bax mRNA detected by molecular viewpoint. RESULTS: Survival rate in the Ad5-HO-1 group was significantly higher than that in the saline group at al,7,and 21 days after liver transplantation(P＜0.05).Glutamic pyruvic transaminase decreased in the Ad5-HO-1 group as compared to that in the saline,Ad5-GFP,and Ad5-HO-1+ZnPP groups(P＜0.05);portal venous blood flow significantly increased 2 hours after transplantation(P＜0.05);HO-1 activity also significantly increased(P＜0.05).RT-PCR and immunohistochemical staining showed that HO-1 and bcl-2 expressions increased(P＜0.05),but bax and TNF-αexpressions decreased(P＜0.05).CONCLUSION:Ad5-HO-1 significantly induces high expression of HO-1 increases portal venous blood flow within 2 hours alter liver transplantation, and promotes liver functional recovery so as to prolong survival time of rats after liver transplantion.

After the problems in military postgraduate information literacy education were analyzed, the construction of a systematic and coherent information literacy education course system for military postgraduates in close combination with their subjects was proposed by setting up multidimensional education target, designing three-stage foundation-subject-innovation course, combining traditional literature retrieval course and embedded professional course, combining case teaching, heuristic discussion and innovative talent information literacy training approach, by infiltrating the physical and virtual space both in and outside university, and by participating in the study and research activities of postgraduates.