ObjectiveTo Summarize the experience of totally thoracoscopic operation for atrial myxoma.Methods From December 2007 to November 2011,44 patients with atrial myxoma,including 37 cases of Left atrial myxoma,6 cases of Right atrial myxoma,1 case of double atrial myxoma were treated totally under thoracoscope.Surgical procedures were performed through 3 troears inserted at the right chest wall,and catheters were placed in the right femoral artery and vein (or in the right atrium,femoral vein)to set up extracorporeal circulation.The ascending aorta was cross-clamped with long tailor-made forceps and the myocardium was protected by coronary perfusion with cold crystalloid (blood) cardioplegia.ResultsAll the operations were completed successfully.The mean extracorporeal circulation and cross-clamping time were (49 ± 18 )min and (28 ± 10) min respectively.Postoperative ventilation was withdrawn in(3.8 ± 1.4) h,and the patients were discharged from the hospital in (6.8 ± 1.3 ) d.3 of the patients had postoperative complications,including 1 case of fat liquefaction of the incision at the right groin ( delayed healing),2 cases of subcutaneous emphysema ( healed by bandaged chest).No severe complications occurred in this series.UCG performed 3 - 5 days after the operation revealed surgical results were satisfactory.Followup up to 2 months to 4 years were available in all cases.During the period,the heart function was confirmed as level Ⅰ.ConclusionVideo-assisted thoraeoseopie cardiac surgery is feasible,safe,and minimal invasive for patients,resulting in quick recovery and good cosmetic outcomes.

ObjectiveTo summarize the experience of totally thoracoscopic operation for congenital heart diseases.MethodsFrom September 2000 to November 2011,1281 patients with congenital heart disease,including 1016 cases of atrial septal defect,110 cases of ventricular septal defect,61 cases of atrioventricular tube defects,33 cases of tetralogy of Fallot,24 cases of part anomalous pulmonary venous connection,12 cases of pulmonary valve stenosis,9 cases of patent ductus arteriosus,8 case of triatriatum,7 cases of unroofed coronary sinus syndrome,and 1 case of total anomalous pulmonary venous connection were treated totally under thoracoscope.Surgical procedures were performed through 3 troears inserted at the right chest wall,and catheters were placed in the right femoral artery and vein ( or in the right atrium,femoral vein) to set up extracorporeal circulation.The ascending aorta was cross-clamped with long tailor-made forceps and the myocardium was protected by coronary perfusion with cold crystalloid (blood) cardioplegia.ResultsAll the operations were completed successfully.The mean extracorporeal circulation and cross-clamping time were ( 42 ± 16 ) min and ( 21 ± 9 ) min respectively.Postoperative ventilation was withdrawn in(4.1 ± 1.5 ) h,and the patients were discharged from the hospital in(7.1 ± 1.4) d.35 of the patients had postoperative complications,including 16 cases of right pneumothorax (healed by thoracentesis),12 cases of subcutaneous emphysema ( healed by bandaged chest) and 7 cases of fat liquefaction of the incision at the right axillary( 3 cases) and groin(4 cases) ( delayed healing).No severe complications occurred in this series.UCG performed 4 - 8 days after the operation revealed no residual shunt.Follow-up up to 3 months to 9 years were available in 914 cases.During the period,the heart function was confirmed as level Ⅰ - Ⅱ.ConclusionTotally thoracoscopic cardiac surgery is feasible,safe,and minimal invasive for patients,resulting in quick recovery and good cosmetic outcomes.

Objective To explore the relationship between the impairment of hematological system and disease activity,immunological parameters,and the prognosis of systemic lupus erythematosus (SLE).Methods The clinical and laboratory data of in-patients with SLE in Jiangsu Province were investigated and all patients were hospitalized between 1999-2009.The impairment of hematological system was assessed and the relationship between hematological system damage and disease activity,immunological parameters,mortality rate of patients with SLE were analyzed.Statistic method used was X2 test.Results One thousand nine hundred and fifty eight cases of SLE were included in the study,in which,1836 were female and 122 were male.One thousand five hundred and forty nine (79.1%) patients complicated with hematological system damage,62.3% were anemia,45.5% with leucopenia and 29.4% with thrombocytopenia.There were significant differences in hematological system damage rate among patients with mild activity group,moderate activity group,severe activity group and almost no activity group,compared respectively with almost no activity group.The P values were P=0.01 and P＜0.01 respectively.The incidence of hematological system damage in elevated ESR,low complement C3 level,anti-dsDNA antibody group was higher than that in patients who had normal ESR,complement C3 level and anti-dsDNA group.(P＜0.01).During follow-up,166 patients died,of which the mortality rate(91.6%) in patients had hematological system damage,was obviously higher than those without hematological damage(8.4%)(P＜0.01 ).Among the 166 deceased patients,38.6% died of severe infection,22.9% died ofrenal failure,15.1% died ofnervous system damage,10.2% died of cadiovascular damage and 13.3% died from other causes.Conclusion Hematological system is one of the most commonly involved system in patients with SLE,of which anemia is the most common,and the incidence of leukopenia follows.The impairment of hematological system is closely related to lupus activity.Patients with abnormal immune parameters tend to have secondary hematological system damage.Severe infection is the main cause of death in patients with lupus,followed by nervous system damage and kidney damage.The mortality rate in patients with lupus that complicated hematological system damage is higher than patients who have no hematological system damage.

Aim To investigate the effect of U50488H(a selective κ-opioid receptor agonist)and isoproterenol(ISO,a β-adrenergic receptor agonist)on ventricular arrhythmias and Cx43 during myocardial ischemia and reperfusion in rats.Methods 60 rats were randomly divided into five groups,ie,normal control group,I/R group,ISO+I/R group,U50488H+ISO+I/R group,Nor-BNI+U50488H+ISO+I/R group.The incidence of ventricular arrhythmias and arrhythmia score were determined. The expression of Cx43mRNA was tested by RT-PCR.The expression of Cx43 protein in myocardial cell was tested by an immunohistochemical approach with a quantitative imaging system.Results ① Compared with the I/R group,arrhythmia score was increased with administration of ISO(P<0.05).U50488H intravenously injected before ISO significantly decreased the arrhythmia score(P<0.05).② Compared with the normal control group,the expression of Cx43 mRNA was decreased in the I/R group(P<0.05).With administration of ISO,the amount of Cx43 mRNA was not significantly increased.③ Compared with normal control group,total and phosphorylated Cx43 proteins were significantly decreased in the I/R group(P<0.05),and the phosphorylated Cx43 was also decreased with administration of ISO.Compared with ISO+I/R group,phosphorylated Cx43 was increased with administration of U50488H (P<0.05).Conclusion κ-opioid receptor agonist U50488 H antagonizes the arrhythmias through the regulation of Cx43 during myocardial ischemia and reperfusion via inhibiting β-adrenergic receptor pathway.

0.05).Compared with group A,the aortic occlusion time,ventilation time and the length of stay in ICU were shorter in groups B and C(P0.05)were found between group B and C in the aortic occlusion time,ventilation time and length of stay in ICU.Conclusion TTS is a safe and reliable surgical madality for the treatment of pediatric cardiac diseases.Patients weighed over 20kg are strong enough to withstand TTS and may recover sooner.

Polysaccharide sulphate (PSS) 1. 8, 5. 4 and 18mg ? kg-1 ig could remarkably reduce blood glucose of alloxan - induced diabetes in rabbits . The doses of PSS could decrease the high blood glucose caused by adrenaline . PSS 1. 8 and 5. 4mg ? kg-1 could not reduce blood glucose concentration in normal rabbits, but PSS 18mg ? kg-1 could do. The glucose to lerance test showed that PSS 5. 4 and 18mg ?kg-1 could reduce the increase of blood glucose level caused by glucose loading after administration of glucose in rats (5g ? kg-1, ig) and could also persistently decrease blood glucose of alloxan - induced diabetes in rats after the doses of PSS ig for 5d.