Correlation of blood flow assessed by CT perfusion imaging and microvascular ultrastructure in non-small cell lung cancer: a preliminary study / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the correlation between blood flow assessed by CT perfusion imaging and characteristics of microvascular ultrastructure in non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>twenty-eight patients with non-small cell lung cancer proven surgically and pathologically underwent perfusion CT examination. The patients were divided into a hyper-perfusion group and a hypo-perfusion group by the median value of blood flow, and then the differences of microvascular ultrastructure in the two groups were analyzed.</p><p><b>RESULTS</b>The median BF value of the 28 patients was 36.40 ml×100 g(-1)×min(-1). Take this median value as the boundary, the group with hypo-perfusion showed a significantly lower BF value than the group with hyper-perfusion [(30.84 ± 4.79) ml×100 g(-1)×min(-1) vs. (49.67 ± 10.89) ml×100 g(-1)×min(-1), t = -5.925, P < 0.001]. The group with lymph node metastasis showed a significantly lower BF value than the group without lymph node metastasis [(30.78 ± 5.24) ml×100 g(-1)×min(-1) vs. (50.73 ± 11.16) ml×100 g(-1)×min(-1), t = 3.490, P = 0.015]. The maturity of microvessels of the hyper-perfusion group was higher than that of the hypo-perfusion group. Under the electron microscope, the microvessels in the hypo-perfusion group showed a more narrow lumen, poorer integrity of basement membrane, a more close relationship between cancer cells and microvascular wall, and cancer cells were more easily seen in the microvascular lumen.</p><p><b>CONCLUSION</b>The blood flow value of CT perfusion imaging may be related with the abnormal microvascular ultrastructure, and may be helpful to the prediction of metastasis risk in NSCLC.</p>

Clinical study of lung mucoepidermoid tumors / 中南大学学报(医学版)

OBJECTIVE@#To investigate clinical and pathological characteristics of lung mucoepidermoid tumors and summarize methods for diagnosing and treating it.@*METHODS@#Records of a total of 2,751 consecutive patients with lung cancer were reviewed and 10 of whom with mucoepidermoid tumors were identified. Chest radiographs, computer tomographs, and bronchoscopes were performed to all of them. Eight of them underwent thoracotomy and some also received chemotherapy and/or radiotherapy. One patient received Chinese herb therapy only while another did not receive any therapy.@*RESULTS@#Pathological examination showed that the 10 patients had low-grade mucoepidermoid tumors. All patients were alive. Seven patients who received thoracotomy did not recur. One patient whose tumor was located in trachea recurred 5.2 years after the operation.@*CONCLUSION@#Bronchoscope can play an important role in the process of diagnosis. Pathological staging is vital for prognosis. Lung mucoepidermoid tumors should be treated with complete surgical resection with lymph node sampling and dissection and close follow-up.

Fifty-three cases of valve repair for mitral insufficiency / 中南大学学报(医学版)

OBJECTIVE@#To summarize the experience of mitral vavuloplasty for mitral insufficiency in 53 patients.@*METHODS@#Between January 2001 and September 2006,53 patients (31 males and 22 females) with mitral insufficiency underwent mitral valve repair at our hospital. The mean age was (23.8+/-10.4) years, and the mean weight was (43+/-12) kg,including 29 cases of mitral prolapse,17 congenital mitral insufficiency, 5 rheumatic mitral insufficiency,and 2 other etiology. All operations were performed under cardiopulmonary bypass,moderate hypothermia and under the surveillance of transesophagus echocardiography.@*RESULTS@#There were 2 early postoperative deaths,and another patient failed to repair and received valve replacement afterward. Postoperative echocardiography indicated that mitral insufficiency was completely corrected in 42 patients, and residual mitral regurginitation in the other 8 patients. During the follow-up with mean period 13.8 months,41 patients revealed 28 in NYHA classI,13 in Class II.@*CONCLUSION@#Mitral valve repair should be the preferred modes of surgical correction for regurgitate mitral valves. With proper vavuloplasty technique, patients with selective mitral insufficiency patients may achieve satisfactory effect.

Pneumonectomy for 210 cases of lung cancer / 中南大学学报(医学版)

OBJECTIVE@#To summarize 210 cases of lung cancer that underwent pneumonectomy,and to study the therapy value of pneumonectomy for lung cancer.@*METHODS@#Between January 1993 and December 2004,210 patients (169 males and 41 females) with lung cancer underwent pneumonectomy in our hospital with the mean age of 54.77 years. Out of the 210 cases 144 had left pneumonectomy, and 66 had right pneumonectomy. Among them, 26 experienced intrapericardial pneumonectomy,1 inferior vena cava reconstruction, and 1 carina reconstruction. All bronchial stumps were closed by manual suture,and systemic node dissection was performed routinely.@*RESULTS@#No one died during the operation, but 59 patients (28.10%) experienced postoperative complications and 9 patients (4.28%) died within 30 days of operation. After exclusion of postoperative deaths, the 1-year, 3-year, and 5-year survival rates were 66.21%,36.13% and 24.26%, respectively. Only 1 out of the 12 patients with small cell carcinoma survived more than 3 years.@*CONCLUSION@#Mortality and morbidity were high in pneumonectomy.If we carefully and properly select the patients, enhance postoperative monitoring and perioperative treatment, and combine with chemo-and/or radiotherapy,pneumonectomy will surely be effective for patients with lung cancer.

Protection of cadaver lungs of non-heart-beating donor lung transplantation in rats / 中南大学学报(医学版)

OBJECTIVE@#To investigate the methods to alleviate lung injury of non-heart-beating donor to attain better structure and function.@*METHODS@#Sixty-four Sprague-Dawley rats were randomly divided into 4 groupsú a heart-beating donor group(HBD group), a non-heart-beating donor group without protective measures(NHBD-N group), a non-heart-beating donor group with continuous mechanical ventilation or with topical cooling on cadaver lung (NHBD-V group and NHBD-I group). After the transplantation, lung compliance,pulmonary function,wet/dry ratio of lung and content of energy metabolism were compared among the 4 groups.@*RESULTS@#Due to the longer warm ischemic period, NHBD lungs suffered more injuries than HBD lungs. However, compared with NHBD-N group, the wet/dry ratio of the lung in NHBD-V group and NHBD-I group was lower(5.28+/-1.24,4.21+/-0.85,4.14+/-1.33,P<0.01),the lung injury index (14.35+/-3.21,11.28+/-3.26,10.41+/-2.85, P<0.01)and the count of white blood cells(425.60+/-86.47,316.30+/-56.24,295.50+/-70.26, P<0.01) were milder, while the lung compliance and preservation of energetic metabolte were better in the NHBD-V group and the NHBD-I group.@*CONCLUSION@#Continuous mechanical ventilation or topical cooling may protect the NHBD lung during the warm ischemic period.

Effect of cariporide on the expression of bcl-2 and bax genes after neck heart transplantation from non heart-beating rats caused by warm ischemia / 中南大学学报(医学版)

OBJECTIVE@#To detect the expression of bcl-2 and bax genes after heterotopic heart transplantation in rats that died of warm ischemia, and to explore the effect of cariporide on the protection of the ratos non heart-beating donors.@*METHODS@#One hundred and twelve clearing Sprague-Dawley male rats were divided into 7 groups at random (each group contained 16 rats): the control group (Group C), the groups of transplanted hearts after 10, 30, and 45 min of asystolia (Group S10,S30,and S45), and the groups of transplanted hearts after 10,30, and 45 min of asystolia and infused with cariporide(Group SH10,SH30, and SH45).The experimental groups were sacrificed totally by warm ischemia, and heterotopic heart transplantation was processed by the Cuff method. The heart samples of S10,SH10,S30, and SH30 groups were taken at 48 hours after the transplantation, and the heart samples of S45, and SH45 groups were taken just after transplantation. The expression of bcl-2 and bax genes were detected by RT-PCR.@*RESULTS@#The death of rats was affirmed when cardiac electric waves vanished after 9~11 minutes of transsection of abdominal aorta. On the RT-PCR test, the expression of bcl-2 gene was the highest and ROD value was maximum in the control group. The expression of bax gene was the lowest and ROD value was minimum in the control group. The ROD value of bcl-2 genes in S10 and S30 groups was less than that in SH10 and SH30 group. The ROD value was just the opposite, and there was stastistical difference (P0.05).@*CONCLUSION@#The model of heteroto-pic neck heart transplantation is a convenient animal model for the cardiac muscle protection. Cariporide can suppress the apoptosis of cardiac muscle cells in rats (within 30 min) after death caused by warm ischemia.

Effect of HOE642 on cardiac myocyte apoptosis in rat non heart-beating donors / 中国医学科学院学报

<p><b>OBJECTIVES</b>To investigate the effect of HOE642 on cardiac myocyte apoptosis of the heterotopic heart transplantation of rat non heart-beating donors.</p><p><b>METHODS</b>Totally 112 male Sprague-Dawley rats were randomly divided into 7 groups (n=16 in each group) C, the control group (normal hearts); S10, S30, and S45 (groups of transplanted hearts after 10, 30, and 45 minutes of asystole); and SH10, SH30, and SH45 (groups of transplanted hearts after 10, 30, and 45 minutes of asystole and infused with HOE642). After rata in the experimental groups were killed by warm ischemia the donators of the S10, S30 and S45 groups were infused with 5TH-1 for 30 minutes, and the dead rats in group SH10, SH30, and SH4 were infused with STH-1 and HOE642 (20 micromol/L) for 30 minutes. Heterotopic heart transplantation were processed by the method of neck Cuff. The heart specimens of S10, SH10, S30, and SH30 groups were taken after 48 hours of transplantation, and the heart specimens of S45 and SH45 groups were taken immediately after transplantation. Then apoptotic myocytes were detected with terminal deoxynucleotide transferase-mediated deoxyuridine-biotin nick end labeling method and the expressions of Bcl-2, Bax, and Caspase-3 proteins were detected by immunohistochemistry.</p><p><b>RESULTS</b>The rats were discerned death when cardiac electric wave vanished after 9-11 minutes of bloodletting by transsection of abdominal aorta. The number of positive cardiac muscle cells in S10 and S30 groups were significantly larger than those in group SH10 and SH30 (P < 0.05). The levels of Bcl-2 protein expression in S10 and S30 groups were significantly lower than those in SH10 and SH30 groups (P < 0.05). The levels of Bax and Caspase-3 protein expression were significantly higher than those in SH10 and SH30 groups (P < 0.05).</p><p><b>CONCLUSIONS</b>The rat model of a heterotopic heart transplantation on the cervical part is a convenient animal model for cardiac muscle protection. HOE642 can suppress rat cardiac muscle cells apoptosis (within 30 min) after death caused by warm ischemia.</p>

Mechanical valve replacement in children with heart valve diseases / 中南大学学报(医学版)

OBJECTIVE@#To determine the surgical point and technique of artificial mechanical valve replacement in children with heart valve diseases.@*METHODS@#From Jan. 1989 to Oct. 2005, 63 children under 15 years received mechanical cardiac valve replacement with cardiopulmonary bypass (CPB).@*RESULTS@#The valve replacement included aortic valve replacement in 20 children, mitral valve replacement in 37 children and combined aortic valve and mitral valve replacement in 6 children.@*CONCLUSION@#The operation mortality was 7.94%(5/63). The follow-up periods were from 4 months to 204 months. The late mortality was 10.34%(6/58). All the other children were in NYHA class I - II. The operation mortality of children with heart valve replacement is higher than that of adults, but it was very effective.

Protective effect of lidocaine on injury alveolar Type II cells induced by LPS in adult rats / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of lidocaine on LPS induced apoptosis of cultured adult rat alveolar Type II (AT-II) cells.@*METHODS@#Cultured cells were exposed to LPS and lidocaine for 24 hours. Apoptosis and necrosis rates of cells were detected by flow cytometry and electron microscope. The activity of lactic dehydrogenase (LDH) was analyzed by using LDH kits.@*RESULTS@#LPS induced the AT-II cell injuries by increasing not only the necrosis and apoptosis rates but also the LDH release of cultured AT-II in vitro. Lidocaine decreased the necrosis and apoptosis rates of AT-II cells.@*CONCLUSION@#Lidocaine can directly inhibit the apoptosis and necrosis induced by LPS in cultured AT-II cells.

Effect of cortisol on ischemic preconditioning in rabbit hearts / 中南大学学报(医学版)

OBJECTIVE@#To determine the effects of reacting cortisol on ischemic preconditioning (IPC).@*METHODS@#Thirty rabbits were randomized into ischemic preconditioning (IPC) group, etomidate (Etom) group, ischemic/reperfusion (IR) group, methylprednisolone (MP) group and a control group. The ratios of infarction size versus risk area (Infarct/Risk) were calculated. The elevations of serum CK activity and cTnI concentrations as well as serum cortisol concentrations were measured.@*RESULTS@#The ratios of Infarct/Risk were 5.9%+/-2.8% for IPC, 11.3%+/-3.6% for Etom, 26.8%+/-4.5% for IR and 18.2%+/-3.7% for MP. The elevations of serum CK activity (U/L) were 255+/-89 for IPC, 314+/-160 for Etom, 855+/-371 for IR and 768+/-404 for MP, the elevations of serum cTnI concentrations (microg/L) were 3.6+/-0.6 for IPC, 5.9+/-2.0 for Etom, 8.1+/-3.6 for IR and 6.1+/-2.3 for MP. Those indicators among groups are all significantly different (P<0.01). Cortisol reacting was markedly diminished in Etom group.@*CONCLUSION@#A blunted cortisol reaction can markedly undermine the benefit of ischemic preconditioning, methylprednisolone show a certain myocardial protection. Cortisol may play an important role in the IPC process.

Surgical treatment of cor triatriatum in 15 patients / 中南大学学报(医学版)

OBJECTIVE@#To review the clinical data of pathological morphology, diagnosis, surgical treatment of cor triatriatum in 15 patients.@*METHODS@#Fifteen patients with a mean age of (14.6+/-10.3) years (range from 6 months to 40 years) were performed operations under extracorporeal circulation. Fourteen of the patients had cor triatriatum sinister, and 1 had cor triatriatum dexter; 12 of the 15 patients had other cardiac abnormalities. The excision of the fibromuscular membrane was accomplished through a right atrial incision in all of the 14 cases, and the associated abnormalities were corrected at the same time.@*RESULTS@#One patient died after the operation, and the other survivors had good outcome.@*CONCLUSION@#Operation is necessary if the diagnosis is clear. The patients generally have good prognosis. Surgical results of cor triatriatum depend on the complexity of associated defects and the adequacy of the repair.

Direct observation of the effect of mitral valvuloplasty on beating heart / 中南大学学报(医学版)

OBJECTIVE@#To summarize the method and experience of direct observation of the effect of mitral valvuloplasty on beating heart.@*METHODS@#Twelve patients with mitral regurgitation underwent mitral valvuloplasty. When the heart was beating slowly before releasing the aorta, the morphology and function of the mitral valve were evaluated by direct observation. If the results were unsatisfactory, further techniques were used to reach the goal.@*RESULTS@#During the operation 2 patients needed further techniques to make the mitral valve work well. No operative death and only 1 complication (low cardiac output syndrome) occurred. After 1 month follow-up later, mild regurgitation was found in 5 patients, moderate regurgitation in 1 and no obvious regurgitation in 6.@*CONCLUSION@#Evaluating the effect of mitral valvuloplasty by direct observation on beating heart is practicable.

Aortic Valvuloplasty in Treatment of Ventricular Septal Defect with Aortic Valve Insufficiency in Children / 实用儿科临床杂志

Objective To explore the clinical effects of aortic valvuloplasty in treatment of ventricular septal defect(VSD)with moderate or severe aortic valve insufficiency(AI)in children.Methods Thirteen children less than 14 years old underwent open heart surgery as well as aortic valvuloplasty for VSD with moderate or severe AI.There were 9 cases of subpulmonary VSD,perimenbranous VSD in 4 cases.AI was mo-derate in 4 cases,severe in 9 cases.Results There was no hospital death.Post-operative echocardiogram and X-ray revealed that both cardiothoracic ratio and left ventricular end diastolic diameter decreased markedly(P

Protective mechanism of ischemic preconditioning to the lung ischemia-reperfusion injury / 中南大学学报(医学版)

OBJECTIVE@#To determine the protective mechanism of preconditioning to the lung injury induced by ischemia-reperfusion.@*METHODS@#Twelve pigs were randomly divided into 2 groups: control group ( Group C) and ischemic preconditioning group ( Group IP). The concentration of superoxide distrautase (SOD) and malondialdehyde (MDA) in circuit were checked before and after the perfusion to reflect the lipid peroxidation in the lungs. Left lung biopsies were performed immediately after the perfusion and 1 hour postperfusion for histologic examination. The ICAM-1 expression was assessed by immunohistochemical analysis with Envision method and the mRNA expression of ICAM-1 was analyzed by RT-PCR.@*RESULTS@#SOD in Group IP was much higher than that in Group C (P < 0.01 ). MDA in Group IP was much lower than that in Group C ( P < 0.01 ). The lung histologic examination showed that Group C was significantly more serious than Group IP in pulmonary edema, inflammatory cell infiltration, mild focal hemorrhage, and alveolar disruption. The expression of ICAM-1 of lung tissue obviously decreased in Group IP than that in Group C (P <0.01 ). The expression of ICAM-1 mRNA of lung tissue was significantly lower in Group IP than that in Group C (P < 0.01 ).@*CONCLUSION@#Lung ischemic preconditioning can reduce the lung injury. The mechanisms of the protective effects of the IP may be related to the increase of SOD and the decrease of MDA. The preconditioning down-regulated the ICAM-1 expression is one of the mechanisms in reducing the lung injury.