Simultaneous minimally invasive technique for congenital heart disease and pectus excavatum / 中华胸心血管外科杂志

Objective To investigate the safty and feasibility of simultaneous minimally invasive technique for congenital heart disease (CHD) and pectus excavatum (PE).Methods From July 2006 to June 2011,6 children with PE associated with CHD were treated by simultaneous minimally invasive technique.They were 4 boys and 2 girls,aged from 4 years to 6 years 5 months ( average 5 years and 4 month),.The body weight were from 16 kg to 20 kg [ average ( 18.00 ± 1.79kg ].CT Hailer index were 3.9 - 5.0 ( average 4.35 ± 0.43 ).4 patients with ventricular septal defect (VSD) were treated by minimally invasive closure device,including 3 membranous VSD and 1 subaortic VSD.The defect diameter was 4 - 5 mm.2 cases with atrial septal defect (ASD) were treated using the same technique.the diameter of ASD was 12 - 16 mm.After minimally invasive heart surgery,Nuss operation was carried out in all 6 patients for their PE.Results All operations were successful and patients were extubated 5 - 11 h after operation [ mean ( 8.17 ± 2.04) h ].The pericardial mediastinal drainage was removed at 48 h postoperatively.There were no operative mortality and severe postoperative complications.1 patient had delayed wound healing and was successfully discharged.The plate was removed in 3 cases,and they all had satisfactory outcomes.Conclusion Simultaneous minimally invasive technique is a safe and effeictive mothod for treating pectus excavatum and congenital heart disease.

Therapeutic effect of mild hypothermia on severe traumatic head injury / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of mild hypothermia on severe traumatic brain injury.</p><p><b>METHODS</b>Eighty-six in-patients with severe traumatic brain injury treated ordinarily were consecutively randomized into two groups: a hypothermia group (n=43) and a normothermia group (the control group, n=43). In the hypothermia group, the core temperature (i.e., nasopharyngeal or brain temperature) of the patient was reduced to and maintained at 33-35 degrees C with a systemic cooling blanket. Natural rewarming began after 3-5 days (mean: 4.3 days) of hypothermia treatment. In the control group, the patient received no hypothermia treatment. The vital sign, extradural pressure and serum superoxide dismutase were observed and measured during treatment, and the complications as well as the Glasgow outcome scale were evaluated at 2 years after injury.</p><p><b>RESULTS</b>The mean extradural pressure in the hypothermia group (27.38 mm Hg +/- 4.88 mm Hg at 24 hours, 29.40 mm Hg +/- 4.50 mm Hg at 48 hours and 26.40 mm Hg +/- 4.13 mm Hg at 72 hours after injury) was much lower than that in the control group (32.63 mm Hg +/- 3.00 mm Hg, 34.80 mm Hg +/- 6.00 mm Hg and 31.81 mm Hg +/- 4.50 mm Hg respectively at 24, 48 and 72 hours, P<0.05). The mean serum superoxide dismutase levels in the hypothermia group on days 3 and 7 (583.7 microg/L +/- 99.6 microg/L and 699.4 microg/L +/- 217.3 microg/L, respectively) were much higher than those in the control group at the same time period (446.6 microg/L +/- 79.5 microg/L and 497.1 microg/L +/- 101.2 microg/L, respectively, P<0.01). The recovery rates at 2 years after injury were 65.1% in the hypothermia group and 37.2% in the control group (P<0.05). The mortality rates were 25.6% in the hypothermia group and 51.2% in the control group (P<0.05). The complications, including pulmonary infections, thrombocytopenia (platelet count < 100 x 10(9)/L), hemorrhage in the digestive tract, electrolyte disorders and renal malfunction, were managed without severe sequelae.</p><p><b>CONCLUSIONS</b>Mild hypothermia is a safe and effective therapeutic method, which can lower the extradural pressure, increase the serum superoxide dismutase and improve the neurological outcomes without severe complications in the patients with severe traumatic brain injury.</p>

Effect of intravenous injection of corticosterone on the presympathetic neurons in rostral ventrolateral medulla of rats / 第二军医大学学报

Objective: To study the role of glucocorticoid i n the integration of sympathetic nervous system and cardiovascular activity. Methods: Neurons in the rostral ventrolateral medulla (RVLM) were extracelluarly recorded and identified as the presympathetic neurons of adult rats. The spontaneous discharge of the presympathetic neurons in the RVLM were observed by bolus intravenous injection of corticosterone (50, 100, 150 μg/kg） . Results: The firing rate of 12 presympathetic neurons was incr eased by intravenous application of corticosterone (P<0.05), and this effect showed a dose-dependent manner. The latency of excitatory effect was (104±2 5) s. Conclusion: Corticosterone can rapidly excite the presym pathetic neurons in the RVLM, this action might be involved in the integration o f sympathetic nervous system through the “rapid membrane effects”.

Effect of intravenous injection of corticosterone on the presympathetic neurons in rostral ventrolateral medulla of rats / 第二军医大学学报

Objective: To study the role of glucocorticoid i n the integration of sympathetic nervous system and cardiovascular activity. Methods: Neurons in the rostral ventrolateral medulla (RVLM) were extracelluarly recorded and identified as the presympathetic neurons of adult rats. The spontaneous discharge of the presympathetic neurons in the RVLM were observed by bolus intravenous injection of corticosterone (50, 100, 150 μg/kg） . Results: The firing rate of 12 presympathetic neurons was incr eased by intravenous application of corticosterone (P<0.05), and this effect showed a dose-dependent manner. The latency of excitatory effect was (104±2 5) s. Conclusion: Corticosterone can rapidly excite the presym pathetic neurons in the RVLM, this action might be involved in the integration o f sympathetic nervous system through the “rapid membrane effects”.