Objective To explore the changes of left atrial systolic function in patients with coronary heart disease after coronary artery bypass grafting (CABG). Methods Strain rate imaging (SRI) was performed on 23 patients with coronary heart disease before CABG, 1 week, 1 and 3 months after CABG to evaluate left atrial systolic function quantitatively. Results No significant change of left atrial systolic function was detected 1 week after CABG (P＞0.05 ). E/A and LVEF increased, LAFS, AEF and SRa decreased 1 month after CABG compared with those before CABG (P＜0.05). Three months after CABG, changes turned more significantly (P＜0.01). Left ventricular ejection fraction (LVEF) increased 1 and 3 months after CABG, and its changing rate negatively correlated with those of Sra (r=-0.751,-0.783; all P＜0.01). Conclusion Left atrial systolic function is affected by CABG, presenting as decrease of pump function. SRI can be used to evaluate the atrial systolic function quantitatively and monitor the changing of left atrial systolic function dynamically after CABG.

Objective To analyse the clinical characteristics,therapeutic modalities and prognosis of pulmonary large cell neuroendocrine carcinoma(LCNEC). Methods The clinical data of 14 patients with pulmonary LCNEC confirmed by surgery were retrospectively reviewed. Results No case was correctely diagnosed before surgery.The immunohistochemical amalysis of the specimens revealed the characters of endocrine carcinoma.Twelve cases received adjuvant chemotherapy of platinum agents,but recurrence or metastasis was found in 8 of them several months after surgery.The median survival time was 19 months.The 1-year,2-year and 3-year survival rate were 85.7%(12/14),21.4%(3/14) and not more than 14.3%(2/14),respectively.The statistical analysis showed that the stage,lymph node metastasis and postoperative adjuvant chemotherapy may have impacts on the prognosis of pulmonary LCNEC. Conclusion Pulmonary LCNEC is a carcinoma with poor prognosis,high tendency of invasion and metastasis.The stage of disease,lymph node metastasis,and adjuvant chemotherapy may be related to the prognosis.

Objective To explore the effect of coronary artery bypass grafting(CABG) on left atrial (LA) function by strain rate imaging(SRI). Methods Twenty-three patients with coronary heart disease who underwent coronary artery bypass grafting were involved. SRI was performed on those patients to evaluate LA function quantitatively at baseline (before CABG),and at 1 week, 1 month and 3 months after CABG. Peak strain rate(SR) was measured at each segment (septal, lateral, posterior, anterior, and inferior walls) and mean peak systolic SR (SRs),peak early diastolic SR (SRe) and peak atrial systolic SR (SRa) were calculated by averaging data in each segment. Results Compared with the baseline,LV pre-systolic volume(LAVp), maximal volume (LAVmax), minimal volume (LAVmin), LV active emptying fraction (LAAEF) and passive empting fraction(LAPEF) had on significant differences at 1 week (P >0.05). LAVp,LAVmin,LAVmax and LAAEF decreased gradually after CABG, LAPEF increased gradually after CABG (P <0.05). Compared with the baseline, the peaks of SR curve showed no significant differences at 1 week (P >0.05). Nevertheless,the peaks of SR were increased at systole and early diastole,decreased at atrial contraction at 1 month (P <0.05). Those changes were turned more significantly at 3 months (P 0.01). Left ventricular ejection fraction (LVEF) both increased at 1 month and 3 months,and its changing rate correlated inversely with the changing rate of SRa respectively (r = -0.751, -0.783,all P<0.01).Conclusions LA function is affected by CABG, presented as reservoir and pump functions decreased and conduit function increased. SRI can evaluate the atrial function quantitatively and monitor the changing of LA function dynamically after CABG.

OBJECTIVETo evaluate the surgical therapeutic strategy and prognostic factors for non-small cell lung cancer (NSCLC) with mediastinal lymph node metastasis (N2).

METHODSThe survival rate of 117 patients with N2 NSCLC treated surgically from January 1999 to May 2003 were analyzed. There were 88 male cases and 29 female cases, aged from 29 to 79 years. The procedure of operation (lobectomy, pneumonectomy and palliative resection), histological classification (squamous cell carcinoma, adenocarcinoma, mixed carcinoma, and large cell carcinoma and others), T primary tumor status, and adjuvant therapy were analyzed to determine their impact on the 5-year survival rate.

RESULTSThe median survival time was 22 months, and the over-all 3- and 5-year survival rate was 28.1% and 19.0%. Survival was higher in patients with lobectomy than with palliative resection, with T1 and T2 than with T4. The 5-year survival rate had no deference in age, sex and different histological classification. The 5-year survival rates of lobectomy and pneumonectomy (22.2% and 25.0% respectively) was higher than palliative resection (9.1%).

CONCLUSIONSSurgical procedures (especially lobectomy) is the best choice for N2 NSCLC patients with T1 or T2. But it can not prolong T4 patients' life significantly.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; pathology ; surgery ; Lymphatic Metastasis ; pathology ; Male ; Mediastinum ; pathology ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; methods ; Prognosis ; Retrospective Studies ; Survival Analysis

OBJECTIVE To study the differentiation of PC12 cells induced by total salvianolic acid (Tsa) and the mechanism. METHODS MTT assay was used to detect the effect of Tsa 0.01, 0.1 and 1.0 μg·L-1on proliferation of PC12 cells and on the cells damaged by oxygen and glucose deprivation (OGD).The number of projections of PC12 cells was statistically analyzed.Western blotting was applied to detect the levels of microtubule-associated protein2 (MAP-2), extracellular signal-regulated kinase1/2 (ERK1/2), phosphorylated ERK1/2(p-ERK1/2), mitogen-activated protein kinase kinase1/2(MEK1/2) and p-MEK1/2 proteins.MEK inhibitor U0126 was examined for its effect on expressions of p-ERK1/2 and ERK1/2 protein in PC12 cells induced by Tsa 1.0 μg·L-1.RESULTS Compared with normal control group, Tsa 1.0 μg·L-1could promote PC12 cell proliferation, and the survival rate was increased by 90%, but the survival rate of PC12 cells was not affected by Tsa 0.01 or 0.1 μg·L-1. Compared with OGD injured group,PC12 cells injured by OGD could be repaired by Tsa 0.1 or 1.0 μg·L-1,and the survival rate was increased to (47.7±1.8)% and (63.2±13.0)%, respectively (P<0.05, P<0.01). Compared with normal control group,Tsa 0.01,0.1 and 1.0 μg·L-1could promote the growth of PC12 cell projections (P<0.01). Western blotting results showed that Tsa could promote the expressions of MAP-2, p-ERK1/2 and p-MEK1/2 proteins, and this effect could be blocked by U0126 inhibitor (P<0.01). CONCLUSION Tsa can induce the proliferation and differentiation of PC12 cells, the mechanism of which is possibly the activation of p-MEK and p-ERK1/2.

OBJECTIVETo evaluate the method and effectiveness of rigid-bronchoscopic cryosurgery for advanced central lung cancer.

METHODSForty-eight patients were enrolled in this study from June 2002 to December 2008, including 33 male and 15 female. The average age was 70 years (ranged from 45 to 83 years old). For the 48 patients, 38 cases were patients with advanced central lung cancer who were not suitable for surgery, and the remaining 10 cases were patients with local recurrence in trachea or main bronchus postoperatively. Cryosurgery was performed 120 times for all patients, 2.5 times per patient on average. The trachea or bronchus station, symptom such as dyspnea, hemoptysis, respiratory function and quality of life were observed.

RESULTSThe unblocked ratio of trachea and bronchi was 97%. All patients got satisfied improvement ratio of symptoms, 87.5% for dyspnea, 72.9% for cough, 93.8% for hemoptysis and 62.5% for chest pain. Respiratory function tests showed that both the mean forced expiratory volume in first second and forced vital capacity got an improvement from (1.03+/-0.05) L to (1.85+/-0.13) L and from (1.69+/-0.18) L to (2.96+/-0.14) L respectively (P<0.01). Karnofsky score also got no less than 20 scores improvement. The Follow-up time was 6 to 62 months. The longest survival was 62 months. The median survival time was 20 months. There was no severe perioperative complications and mortality except for 3 cases of moderate exeduation.

CONCLUSIONSCryosurgery is easy to perform with minimal complications. Not only could it provide an effective and rapid control of symptoms caused by central lung cancer, it could also unobstructed bronchus promptly and improve patients' quality of life.

Aged ; Aged, 80 and over ; Bronchoscopy ; Cryosurgery ; methods ; Female ; Humans ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo explore the osteogenic potential of the nano-hydroxyapatite/collagen/calcium alginate composite implanted in animals.

METHODSEighteen 3-month-old New Zealand white rabbits were adopted to prepare 15 mm segmental defect model at the middle part of radius. Rabbit models were randomly divided into experimental group and blank control group. Nano-hydroxyapatite/collagen/calcium alginate was implanted into the defects of experimental group. Four, 8, and 12 weeks after operation, all specimens were examined by X-ray and histological methods.

RESULTSAll the 18 rabbit models entered the final analysis. X-ray showed that osteotylus was seen in the whole defect area in the experimental group 12 weeks after operation, during which osteogenesis was more obvious than in weeks 4 and 8 and the bridge grafting of defect area was obviously visible. In the blank control group, osteotylus was only observed at the two ends of the defects, and no osteogenesis was found in the central part of the defect area. Histological examination showed that new osteoid formation was seen in internal porous zone in the experimental group in weeks 4 and 8; in week 12, more woven bone-like tissues were visible and trabecular-like structure was formed.

CONCLUSIONThe nano-hydroxyapatite/ collagen/calcium alginate has good osteogenic potential.

Alginates ; chemistry ; Animals ; Collagen ; chemistry ; Durapatite ; chemistry ; Glucuronic Acid ; chemistry ; Hexuronic Acids ; chemistry ; Osteogenesis ; Rabbits ; Radius ; anatomy & histology ; Tissue Engineering ; Wound Healing

OBJECTIVETo evaluate the effectiveness of thymectomy for myasthenia gravis (MG) and the relative risk factors for postoperative myasthenic crisis.

METHODSThe clinic data of 78 cases with MG who underwent thymectomy from June 1985 to June 2005 were analyzed retrospectively. The relative risk factors of postoperative myasthenic crisis were analyzed and the differences between new and old region of perioperative management were compared.

RESULTSThe symptom of MG was complete remission in 21 cases, significantly improved in 38 cases, improved in 11 cases and unchanged in 8 cases, respectively. The symptom duration before operation, preoperative serum level of anti-acetylcholine receptor antibody, Osserman stage and pathological type of thymoma were independent relative risk factors for postoperative myasthenic crisis. The new region of perioperative management was significant better than the old one.

CONCLUSIONSurgical treatment shows significant clinical benefits for patients with MG.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Muscle Weakness ; etiology ; prevention & control ; Myasthenia Gravis ; surgery ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Thymectomy ; adverse effects ; methods ; Treatment Outcome

OBJECTIVETo investigate magnetic resonance imaging (MRI) findings of the atypical leiomyoma in the female reproductive system in comparison with the pathological features of the neoplasms.

METHODSA retrospective analysis of the MRI findings and the pathological features was conducted in 24 cases of atypical leiomyoma involving the female reproductive system.

RESULTSAtypical leiomyomas were displayed by MRI as solid tumor mass surrounded by cystic degeneration, pseudotumors, or solid mass with homogeneous signal intensity. Intrauterine lesions were found in 19 cases, involving the subserosal layer (n=11), intramural region (n=4), broad ligament (n=3), cervix (n=2), submucous layer (n=2), vagina (n=1), and the ovary (n=1). Except for two cases with submucous lesions shown as solid mass, all the cases had lesions appearing as solid cystic mass, whose solid part showed hypo or isointense signals on T1WI and moderate hyperintense signals on T2WI, with heterogeneous enhancement after contrast agent injection. Tumor cell and interstitial cell swelling, vascular hyalinosis, hyalinosis, myxoedema, cystic degeneration, and hemorrhage were found in the lesions.

CONCLUSIONLeiomyoma can occur at almost any site in the female reproductive system, and atypical leiomyoma usually are shown as solid cystic mixed mass in the pelvic cavity. Evaluation of the relationship between the solid mass and cystic portion and observation for the presence of low signal on T2WI may help in the diagnosis of atypical leiomyoma.

Adult ; Aged ; Female ; Genital Neoplasms, Female ; pathology ; Humans ; Leiomyoma ; pathology ; Magnetic Resonance Imaging ; Middle Aged ; Retrospective Studies ; Uterine Neoplasms ; pathology ; Young Adult

OBJECTIVETo analyze the correlation between the perfusion data and microvessel density (MVD) in ovarian tumors, and investigate the hemodynamic features of the tumors in terms of anatomy and functional CT imaging.

METHODSSix patients with surgically confirmed benign ovarian tumors and 6 with malignant ovarian tumors underwent multi-slice CT perfusion imaging to acquire the perfusion parameters including perfusion, PEI, TTP, BV peak enhancement image(PEI), time to peak(TTP) and blood volume(BV). The tumors were stained and counted by Immunohistochemical staining of the microvessels in the tumor was performed to detect the MVD.

RESULTSs The time-density curves of the benign ovarian tumors increased slowly, reaching the peak at 40 s; the curves of the malignant tumors rose rapidly and continuously and reached the peak at 25 s. The differences in the perfusion data (PEI, TTP, BV) were statistically significant between the benign and malignant tumors (P<0.05). The MVD of the malignant tumors was significantly greater than that of the benign tumors (P<0.05). The mean BV of the malignant ovarian tumor was positively correlated to MVD (r=0.786, P<0.05).

CONCLUSIONMulti-slice spiral CT perfusion imaging can provide accurate enhancement data of the ovarian tumors and helps in the diagnosis and differential diagnosis of the ovarian tumors by presenting the changes of the hemodynamic features in the tumors.

Adult ; Aged ; Capillaries ; pathology ; Cystadenocarcinoma ; blood supply ; diagnostic imaging ; Female ; Fibroma ; blood supply ; diagnostic imaging ; Humans ; Middle Aged ; Ovarian Neoplasms ; blood supply ; diagnostic imaging ; Tomography, Spiral Computed ; methods