Microwave and ultrasound have been demonstrated to be outstanding process intensification techniques for transesterification of oil. According to their mechanisms, simultaneous effects can surely bring about better enhancement than sole microwave or ultrasound. Therefore, this study aimed to investigate the important factors and their suitable levels in the KOH-catalyzed transesterification of soybean oil with methanol by using synergistic assistance of microwave-ultrasound (CAMU). The feasibility of application of CAMU in transesterification of oil was demonstrated. When the dosage of methanol, soybean oil and KOH were 15.4g, 34.7g (with methanol-to-oil molar ratio of 12:1) and 1g, respectively, and the microwave power, ultrasonic power, ultrasonic mode, reaction temperature and reaction time were 700W, 800W, 1:0, 65°C and 6min, respectively, the transesterification reached 98.0% of yield, being the highest yield among all the results obtained; while by using 600W of microwave plus stirring instead of CAMU, only 57.4% of yield could be obtained. Compared with other reaction techniques, the transesterification by applying novel CAMU was found to have remarkable advantages. Furthermore, by monitoring the variation of real-time temperature and microwave power during transesterification reactions with different microwave operation time and by taking comparison of the corresponding yield, it was demonstrated that the main reason for the acceleration of microwave-assisted transesterification was the polarization and further activation of reactants caused by microwave irradiation, but not the factor of fast heating.

Simultaneous distillation extraction (SDE) is quite useful for the separation of volatile compounds from an analyte when their contents are quite low. In this study, a simplified SDE approach is applied for the extraction of essential oil from Schisandra sphenanthera, with microwave as heating source, [Bmim][Cl] as the medium for pretreatment, and gas chromatography-mass spectrometry as the analytical approach. Consequently, the improvement resulted from [Bmim][Cl] pretreatment is demonstrated by taking comparison with blank experiments. Totally 61 compounds have been detected in the essential oil obtained by using [Bmim][Cl] pretreatment, while without [Bmim][Cl] pretreatment, only 53 compounds can be detected. Moreover, [Bmim][Cl] pretreatment can also resulted in a higher yield of essential oil. The experimental results demonstrate that the simplified SDE coupled with ionic liquid pretreatment is a feasible approach for the extraction of essential oil from S. sphenanthera with high efficiency as 0.85% of essential oil yield has been obtained, and can be potentially extended to the extraction of essential oil or other target volatile compounds with low content.

Deep eutectic solvents (DESs) have been gaining much attention in recent years due to their various novel properties.

A novel method of microwave-assisted deep eutectic solvent extraction coupled with solid-phase microextraction was developed to determine the volatile compounds in tobacco by gas chromatography-mass spectrometry. During the process, the deep eutectic solvent played the roles of absorbing medium for microwave radiation, destroyer of cell walls, and solvent for dissolving the compounds released from the cells. Combined with solid-phase microextraction, the volatile components were extracted and concentrated in one step. In this method, several experimental parameters, such as fibre type, deep eutectic solvent type, microwave power, set-up temperature and irradiation time were studied. Compared with microwave-assisted water extraction coupled with solid-phase microextraction, and conventional solid-phase microextraction, more volatile components were obtained with higher responses. It was demonstrated that this method has improved extraction efficiency. Moreover, the proposed method has been applied to analyzing tobacco volatiles from different regions and nine different types of components have been detected. The results indicate that microwave-assisted deep eutectic solvent extraction coupled with solid-phase microextraction is an efficient, environmentally-friendly and fast miniaturization pretreatment technology for the extraction of volatiles from tobacco samples. This is a potentially promising technique for other complex and valuable matrices with low volatile content.

The current study presents the case of a patient with multiple pulmonary nodules as observed by computed tomography. Furthermore, a marginal increase in fluorodeoxyglucose uptake was identified by positron emission tomography. Due to the appearance of multiple small nodules and a history of radical nephrectomy, a hypothetical diagnosis of pulmonary metastasis of a previously excised renal carcinoma was determined, which was confirmed by biopsy. Video-assisted thoracoscopic surgical resection of the nodules was proposed and pathological examination exhibited an unforeseen and rare observation.

胸内吻合口瘘是食管癌术后最严重的并发症之一,发生率在3%～25%,可导致肺部感染、脓胸、呼吸衰竭等多种并发症,病情易反复,治疗时间长,病死率高[1,2].本次研究对食管癌术后胸内吻合口瘘患者采用胸腔镜清创并留置4根胸腔引流管、术后胸腔持续冲洗引流的综合治疗方法,效果满意,报道如下.

目的：回顾分析胸内巨淋巴结增生症(Castleman’s Disease,CD)的病理特点、诊断及外科治疗方法。方法：分析2006-2011年收治的10例胸内 CD 患者,局限型9例,多中心型1例,均行手术治疗。结果：术中存在出血、低血压等并发症,全组病例术后随访12个月-60个月,术后无再发原始症状,1例术后3月发现颈部腋下复发 CD,经放射治疗一次后无复发,余9例预后良好。结论：CD 的确诊依靠病理活检,CT对于术前诊断有积极意义。胸内局限型 CD 经彻底手术治疗可获痊愈,术中存在发生各种并发症可能；少部分胸内多中心型 CD 手术治疗效果尚可,大部分因伴发其他脏器功能障碍预后不佳。

AIM: To investigate the effect of insulin-like growth factor 1(IGF-1) on hypothermic preservation of rat hearts.METHODS: Isolated rat hearts were preserved in Celsior solution with or without IGF-1(10 nmol/L) for 9 h,followed by 60 min of reperfusion.Cell apoptosis was assessed by TUNEL method.The left ventricular developed pressure(LVDP) was recorded.Total Akt protein and phosphorylation of Akt protein were detected by Western blotting.RESULTS: Compared with Celsior solution preservation group,IGF-1 significantly enhanced the LVDP recovery rate,decreased the apoptotic index,and inhibited the opening of mitochondrial permeability transition pore.IGF-1 increased the phosphorylation of Akt in 9 h of hypothemically preserved rat heart,which was inhibited by PI3K inhibitor LY294002.LY294002 also abolished the cardioprotection of IGF-1.17-Allylamino-17-demethoxy-geldanamycin,a heat-shock protein 90(HSP90) inhibitor,inhibited the IGF-1-induced increase in phosphorylation level of Akt and transolation to mitochondria,the improvement of cardiac functions,and the decrease in apoptosis.CONCLUSION: IGF-1 improves the cardiac functions and decreases apoptosis in the hearts under hypothermic preservation.The mechanism might involve in HSP90-dependent translocation in Akt to mitochondria.

BACKGROUND: Successful organ preservation is the premise for clinical organ transplantation. The present study investigated whether heat shock protein 90 (Hsp90) is important in the anti-apoptotic effect of diazoxide in hypothermic preservation rat hearts.METHODS: Isolated rat hearts were preserved in Celsior solution, with or without diazoxide, for 3 to 9 hours, followed by 60 minutes of reperfusion. Cell apoptosis was assessed by terminal deoxynucleotide transferase-mediated deoxy uridine triphosphate nick-end labeling. The left ventricular developed pressure (LVDP) was recorded. Expression of Hsp90 protein and cleavage of Bid were detected by Western blot and polymerase chain reaction.RESULTS: After hypothermic preservation for 3 to 9 hours, the LVDP recovery, rate significantly decreased and cardiomyocyte apoptosis index increased in a time-dependent manner. When compared with the 9-hour preservation group, Celsior solution supplemented with diazoxide significantly enhanced the LVDP recovery rate and decreased the apoptosis index. The cleavage of Bid increased after 9 hours of hypothermic preservation, which was inhibited by Celsior solution supplemented with diazoxide. Hypothermic preservation of rat hearts for 9 hours decreased the expression of Hsp90, whereas diazoxide supplementation significantly increased the expression of Hsp90. The Hsp90 inhibitor 17-allylamino-17-demethoxy-geldanamycin inhibited the diazoxide-induced decrease in cleavage of Bid, improvement of cardiac function, and decrease of apoptosis. Hsp90 inhibitor had no effect on the diazoxide-induced increase of total Cx43 protein expression in hearts preserved 9 hours, but inhibited the diazoxide-induced increase of mitochondrial Cx43 protein level.CONCLUSION: Hsp90 might mediate diazoxide-induced cardioprotection against apoptosis in hypothermic preservation heart by preventing the cleavage of Bid. J Heart Lung Transplant 2011;30:928-34 (C) 2011 International Society for Heart and Lung Transplantation. All rights reserved.

P>Synovial sarcomas are rare tumors and account for only 3% of cardiac malignancies. In this report, we present a case of a primary synovial sarcoma of the left ventricle. (J Card Surg 2010;25:288-290).

我们采用电视辅助胸腔镜外科(video-assisted thoracoscopic surgery,VATS)行部分交感神经切除,治疗手汗症198例.作者自行设计总气管插管、半坐位、双孔道电视胸腔镜径路,对操作技术作了改进,取得满意疗效,现就其操作技术与疗效等进行探讨与评价.

OBJECTIVE: To evaluate the clinical significance of DNA analysis of extoliated esophageal cells in early diagnosis of esophageal carcinoma. METHODS: The exfoliated cells were obtained by the esophagus fleece-pulling. The single-cell suspension was made by mechanical decentralization and then detected by the flow cytometry for DNA analysis. DNA index (DI), G2/G 1, S-phase fraction (SPF), proliferation index (PI), etc were recorded and calculated. The clinical evaluation was made by comparing with the routine cytology examination. RESULTS: The DI of esophageal carcinoma group and the control group was 1.31±0.23 and 1.00±0.03. The Aneuploid rate of esophageal carcinoma group was 70.7%, while that of control group was 4.8%. The G2/G1 for esophageal carcinoma group was 2.071±0.153 and that for control group was 1.996±0.099. There was significant difference between two groups (P<0.05) in SPF and PI. CONCLUSION: DNA analysis of exfoliated esophageal cells can raise the early diagnostic rate of esophageal carcinoma.

心律失常是肺切除术后常见的并发症,肺功能部分丧失是肺叶切除后造成心律失常的非常关键一环[1,2].本研究前瞻性的对围手术期患者加强心肌保护,通过干预,观察是否能减少心律失常的发生,为临床治疗提供参考. 1 资料与方法

<正>冠状动脉瘘指冠状动脉与心腔或大血管之间存在的异常交通,是一种少见的心脏畸形,但在冠状动脉畸形中较为多见。此类患者多数可有症状,需行手术治疗;

OBJECTIVEThe purposes of this study were to analyze the relation between enhancement patterns on dynamic enhanced MRI and histologic microvessel patterns of solitary pulmonary nodules (SPNs) and to address the topic of false-positive findings in differentiating SPNs with dynamic MRI.SUBJECTS AND METHODSSixty-eight patients with 68 pathologically proven SPNs (diameter <or= 30 mm) underwent dynamic 1.5-T MRI. On time-signal intensity curves generated after bolus injection of contrast material, steepest slope, peak height, and enhancement ratios of signal intensity at the first, second, and fourth minutes were calculated. The relation between dynamic MRI values and microvessel density was analyzed. The morphologic differences between malignant SPNs and active inflammatory SPNs also were analyzed. Threshold dynamic MRI values for differential diagnosis were determined.RESULTSThe dynamic MRI values of benign SPNs were significantly lower than those of the other SPNs (p < 0.01). The enhancement ratio at the fourth minute for active inflammatory SPNs was significantly higher than that of malignant SPNs (p < 0.01). A high correlation coefficient (r = 0.87, p < 0.001) was found between steepest slope and microvessel density. With steepest slope 1.5%/s or less, benign SPNs were clearly differentiated from other SPNs. With enhancement ratio at the fourth minute 65% or less, malignant SPNs were differentiated from active inflammatory SPNs with high sensitivity (93%) and high specificity (100%).CONCLUSIONDynamic MRI values reflect the quantitative and morphologic characteristics of microvessels in SPNs and are a useful tool for differentiating SPNs with little overlap.

<正> 曲霉性肺炎多属机会性感染,多数情况下是由于患者机体免疫力低下、使用免疫抑制剂或长期使用抗生素导致菌群紊乱所致。严重的侵袭性曲霉性肺炎可造成肺脓肿,继而形成支气管胸膜瘘、曲霉性脓胸,此时全身使用抗真菌药物疗效不佳。文献仅有少数病例报道,但治疗效果并不理想。我院采用电视胸腔镜手术成功治疗1例侵袭性曲霉性肺炎导致的曲霉性脓胸合并支气管胸膜瘘患者,现介绍如下。患者男,34岁,农民。因"黄疸25 d"于2006年6月23日入院。入院诊断"慢性乙型病毒性肝炎,重型"。入院后给予保肝、抗病毒、维持水电解质平衡等对症治疗及人工肝治疗,2周后因胆红素>500μmol/L,出现严重胆汁淤滞,给予地塞米松10 mg/d,1周;地塞米松5 mg/d,1周;甲泼尼龙

OBJECTIVE To investigate the expression of angiotensin converting enzyme 2 (ACE2) and the changes treated with angiotensin converting enzyme inhibitor (ACEI), and its signal transduction pathway. METHODS Atrial tissues were obtained from 47 patients with RHD undergoing cardiac surgery. The mRNA of ACE2 and ACE were semi-qualified by RT-PCR and normalized to the gene beta-actin. Western blot analysis was employed to examine the expressions of ACE2, ACE, ERK1/2 and phosphorylated ERK (pERK1/2). The atrial tissue angiotensin II (Ang II) content was determined by radioimmunoassay detection. RESULTS The expression of ACE2 was significantly decreased (P < 0.05), the expression of ACE and pERK1/2 were significantly increased (P < 0.05), and the level of atrial tissue Ang II was significantly increased in patients with chronic atrial fibrillation group (CAF) compared with sinus rhythm group (SR) (P < 0.05). Compared with CAF patients treated without ACEI, the expression of ACE2 significantly increased (P < 0.01), and the relative activity of ERK1/2 significantly decreased (P < 0.05), whereas the expression of ACE and the level of atrial tissue Ang II remained unchanged in CAF patients treated with ACEI. CONCLUSIONS The study suggested that the dysequilibrium of ACE/ACE2 might play an important role in the process of atrial fibrillation, which may be related to the activation of ERK1/2 pathway. The clinical effect of long-term treatment of ACEI maybe associated with elevated ACE2 expression but not ACE expression.

患者,女,38岁.咳嗽1月,无高血压史,无病理体征.胸部CT示双肺多发结节呈转移瘤形态.头颅、腹部CT和 ECT骨扫描均无阳性发现.两次肺结节穿刺活检未能明确诊断.治疗:行胸腔镜左肺结节活检术.

Objective To investigate the correlations of lymphatic involvement and perfusion patterns of pulmonary carcinoma derived by dynamic contrast-enhanced MRI as well as the histological microvessel density(MVD)of the tumors.Methods Fifty-eight patients with pulmonary carcinoma were classified into two group according to the pathologic reports:tumors with mediastinum lymphatic involvement and tumors without mediastinum lymphatic involvement. All cases were underwent dynamic contrast-enhanced MR scanning. The parameters of dynamic contrast-enhanced MRI were calculated based on time-signal intensity curves. The correlations of lymphatic involvement and MRI parameters as well as tumors MVD were analyzed. Results Tumors with mediastinum lymphatic involvement (n=35) had significantly higher values of both MVD and SS than those without mediastinum lymphatic involvement (n=23) (MVD=72.37±13.74 vs 42.61±16.18;SS=5.05±1.16 vs 2.57±1.09)(t=7.521;t=8.157,P0.01). With the ROC curve analysis, if the SS 3.8 or MVD 63 was taken as s a threshold to predict lymphatic involvement, high sensitivity of SS(85.7%,30 of 35), MVD (74.3%, 26 of 35) and high overall accuracy of SS (87.9,51 of 58), MVD (82.8%, 48 of 58) could be reached, respectively. The area zone under the ROC curve of SS (AZ_ SS ) tended to have higher value than that of MVD (AZ_ MVD )(0.958 versus 0.920), however, the difference between the values of AZ_ SS and AZ_ MVD was not significant (P=0.09) .Conclusion SS and MVD had good correlation with lymphatic involvement of pulmonary carcinoma, and could be used to predict lymphatic involvement.