Diagnosis and surgical treatment of giant intrathoracic solid tumors / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To summarize the experience in diagnosis and surgical treatment of giant intrathoracic solid tumors.</p><p><b>METHODS</b>The data of surgically treated 36 patients with giant intrathoracic solid tumors were analyzed, including 19 males and 17 females. Complete resection was achieved in 34 cases with superior vena cava angioplasty in 3 cases and ligation of the left anonymous vein in 2 cases. Six patients received postoperative radiotherapy.</p><p><b>RESULTS</b>The symptoms in 32 cases were significantly improved. Two patients (5.6%) died of postoperative respiratory infection and failure. The mean postoperative hospital stay was 14.2 days. Pulmonary edema occurred in 6 cases due to rapid decompression of the lung. Pathological results showed that 25 cases had benign tumors and 11 had malignancy. During the follow-up of 1 to 22 years, all patients with benign tumors were still alive, but the patients with malignant tumors had a mean survival time of only 2.1 years.</p><p><b>CONCLUSION</b>Surgical treatment for giant intrathoracic solid tumors is suggested whenever technically possible. Even though a tumor can not be completely resected, satisfied results could still be achieved if combined with postoperative radiotherapy. Proper anesthesia, satisfied exposure with a suitable incision, appropriate resection pattern and hemostatic method are the keys for successful surgical treatment.</p>

Influence of mimic cardiac rate on hydrodynamics of different mechanical prosthetic cardiac valves in vitro / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To assess the influence of mimic cardiac rate on hydrodynamics of different mechanical prosthetic cardiac valves.</p><p><b>METHODS</b>US-made CarboMedics bileaflet valve, China-made Jiuling bileaflet valve and C-L tilting disc valve were tested via a pulsatile flow simulator in the aortic position. Testing conditions were set at mimic cardiac rates of 55 bpm, 75 bpm, 100 bpm with a constant mimic cardiac output of 4 L/min. The mean pressure differences (deltaP), leakage volumes (L(E)V) and closing volumes (C(L)V) across each valve, and effective orifice areas (EOA) were analyzed.</p><p><b>RESULTS</b>Within physiological range, deltaP, L(E)V, and C(L)V decreased as mimic cardiac rate increased, with a large extent of variance. EOA increased along with an increase in mimic cardiac rate. It was a different response in terms of cardiac rate alteration for different types of mechanical prosthetic cardiac valves.</p><p><b>CONCLUSION</b>Mimic cardiac rate change affects hydrodynamics of mechanical prosthetic cardiac valves. Within physiological range, the hydrodynamic of prosthetic bileaflet valve is better than that of tilting disc valve.</p>

Effects of phospholipase D on cardiopulmonary bypass-induced neutrophil priming / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the relationship between phospholipase D (PLD) activation and neutrophil priming induced by cardiopulmonary bypass (CPB), and try to clarify whether CPB-induced systemic inflammatory response can be attenuated by inhibiting neutrophilic PLD activation.</p><p><b>METHODS</b>Neutrophils were isolated from arterial blood of 8 patients undergoing valve replacement before operation and 30 min after initiation of CPB respectively. Both the preoperative and CPB-stirred neutrophils were subdivided into 5 groups by receiving different experimental interventions: (1) bacterial lipopolysaccharide (LPS, 10 ng x ml(-1)), (2) N-formylmethionylphenylalanine (fMLP, 1 micromol x L(-1)), (3) LPS+fMLP, (4) 1-butanol (0.5%)+LPS+fMLP, (5) vehicle. Elastase and myeloperoxidase (MPO) release was measured for the parameters of neutrophil activation, neutrophil PLD activity was determined by quantitation of choline produced from the stable product of phosphatidylcholine catalyzed by PLD.</p><p><b>RESULTS</b>(1) Preoperative neutrophils treated with LPS+fMLP presented significantly higher PLD activity (13.48+/-2.61 nmol choline x h(-1) x mg(-1)) and released more elastase and MPO than cells treated with vehicle (PLD activity 3.70+/-0.49 nmol choline x h(-1) x mg(-1)), P<0.01), LPS (P<0.01) and fMLP respectively. In 1-butanol+LPS+fMLP group, PLD activity of preoperative neutrophils was lower than that in LPS+fMLP group (P<0.01), besides the release of elastase and MPO decreased sharply below both LPS+fMLP and fMLP groups (P<0.01). In LPS group, PLD activity was higher (P<0.01), while elastase and MPO release did not differ from control. fMLP group presented PLD activity, elastase and MPO release higher than control (P<0.01); nevertheless, lower than LPS+fMLP group (P<0.01). (2) CPB-stirred neutrophils presented prominent PLD activity increment, and even the control level was 3.59-fold of the pre-operative control (P<0.01). PLD activity in LPS+fMLP group was higher than that in other groups. Notably, PLD activity was even nonstatistically lower in 1-butanol+LPS+fMLP group than that in LPS or fMLP group. CPB-stirred neutrophils in LPS+fMLP group released more elastase and MPO than control, LPS, and 1-butanol+LPS+fMLP groups did (P<0.01); however, neither of the release was statistically different from that of fMLP group.</p><p><b>CONCLUSIONS</b>Cardiopulmonary bypass enables neutrophil priming accompanied with significant increase in PLD activity. Inhibition of neutrophil PLD activation attenuates its priming and may alleviate CPB-induced systemic inflammatory reaction.</p>