ObjectiveTo investigate the influence of carotid artery stenosis on the incidence of neurological complication in patients undergoing off-pump coronary artery bypass grafting.MethodsWe prospectively analyzed 176 consecutive patients ≥60 years old undergoing selective off-pump coronary artery bypass grafting (from June 2010 to July 2011 ).Carotid duplex ultrasound screening was used to determine the presence and severity of carotid artery before surgery. Neurological complications 7 days after surgery were compared between the patients with ( ≥75％ ) and without severe carotid artery stenosis ( ＜ 70％ ).Multivariate analysis was used to determine the predictor of severe carotid artery disease.ResultsSixteen patients (9.1％ ) were found to have severe carotid artery stenosis before surgery. Thirty-seven patients (20.8％ ) had single or multiple neurological complications:1 (0.6％ ) had stroke; 12 (6.7％) had hypoxic-metabolic encephalopathy; 21 ( 11.8％ ) had cognitive dysfunction; 3 ( 1.7％ ) had depression.When compared with the counterparts,patients with severe carotid artery stenosis had a higher rate of neurological complications (43.8％ vs 18.8％ ; P =0.044).In multivariate analysis,significant predictive factor for severe carotid artery stenosis was prior stroke ( OR:4.04 ; 95％ CI 1.22-13.37 ).Conclusion Severe carotid artery stenosis alone is a risk factor for neurological complication after off-pump coronary artery bypass grafting and prior stroke is a predictor for sever carotid artery disease.

Objective To evaluate the nutrition status and the prognosis of acute stroke patients with hy-pothyroidism during hospitalization. Methods The clinical data of 28 acute stroke patients with hypothyroidism (study group) and 28 stroke patients with normal thyroid function (control group) were retrospectively analyzed.Results After (10±4) days of hospitalization, hemoglobin and serum albumin levels in study group significantlydecreased ( P < 0. 05 ). The requirement of calories and protein, incidence of pulmonary infections, alimentarytract hemorrhage and diarrhea, and hospital stays were significantly higher in study group than in control group (P < 0. 05 ). Conclusion The nutrition status is poor in acute stroke patients with hypothyroidism, who were more easier to be suffered from clinical complications and worse prognosis.

Objective Research the effect of anti-inflammatory and anti-oxidation drugs on acute stroke patients. Methods 128 patients with acute ischemic stroke are divided into two groups- combined treatment group (71) and control (57). Test serum biomarkers and evaluate neurological function and living ability before and after therapy, compare between groups and intra-group. To observe the effects of combined therapy on serum biomarkers and prognosis in acute stage. Results ( 1 ) MMP-9 of combined treatment group (3.23 ±0. 99) ng/L is higher than control (2. 82 ± 4. 21 )ng/L before therapy (P ＜0. 05). (2) The level of pre-treatment ox-LDL-Ab in combined treatment group ( 0. 08 ± 0. 01 ) U/ml higher than posttreatment (0. 07 ±0. 01 ) U/ml (P ＜ 0. 05 ). The level of pre-treatment NIHSS in control group (5.76 ±6.61) score higher than post-treatment (4.22 ±5.45) score,P＜0.05. Conclusion Combined treatment can degrade serum MMP-9 and ox-LDL in acute ischemic stroke patients, but it can't obviously improve the earlier prognosis.

Embolic stroke of undetermined source ( ESUS ) refers to non-lacunar brain infarcts without definite proximal arterialstenosis or major cardioembolic sources.Paroxysmal atrial fibrillation may be the most important cause of ESUS, thus anticoagulation may be more effective than antiplatelet therapy for secondary stroke prevention to this group of patients.This paper reviews the latest progress on the definition, epidemiology, diagnostic approach, relation to atrial fibrillation and management of ESUS.

AIM : To explore the effects of ASODN targeting survivin on apoptosis in HL 60 cells. METHODS : The cell proliferation was tested by MTT assay, the cell morphological transformation was observed by inverted microscope, the cell apoptosis index was examined by TUNEL, the cell apoptosis rate was precisely detected by flow cytometry, and the expression of survivin mRNA was detected by reverse transcriptase PCR. RESULTS : 5-20 ?mol?L -1 of survivin ASODN showed obviously inhibitory effect on the cell proliferation of HL 60 cells, and the inhibitory effect correlated with time and dosage. The cell apoptosis rate and the expression inhibitory rate of survivin gene in ASODN groups were obviously higher than that in the control group. Effects of antisense oligonucleotide targeting survivin on apoptosis in HL 60 cells$$$$ QI Shi mei, BI Fu yong Department of Biochemistry, Wannan Medical College, Wuhu 241001, Anhui, China ABSTRACT AIM : To explore the effects of ASODN targeting survivin on apoptosis in HL 60 cells. METHODS : The cell proliferation was tested by MTT assay, the cell morphological transformation was observed by inverted microscope, the cell apoptosis index was examined by TUNEL, the cell apoptosis rate was precisely detected by flow cytometry, and the expression of survivin mRNA was detected by reverse transcriptase PCR. RESULTS : 5-20 ?mol?L -1 of survivin ASODN showed obviously inhibitory effect on the cell proliferation of HL 60 cells, and the inhibitory effect correlated with time and dosage. The cell apoptosis rate and the expression inhibitory rate of survivin gene in ASODN groups were obviously higher than that in the control group. [WTHZ CONCLUSION : ASODN targeting survivin can effectively inhibit the expression of survivin mRNA and induce the cell apoptosis, and it indicates that survivin plays an important role in maintaining the proliferation of tumor cells.

Objective To analyze the risk factors and clinical features of stroke following off-pump coronary artery bypass grafting in patients with prior stroke. Methods From January 2006 to July 2009, the clinical information of 437 patients undergoing OPCABC in Anzhen Hospital was collected. The patients were divided into stroke group and non-stroke group according to whether stroke occurred after operation. Preoperative and operative variants were evaluated by univariate and multivariate logistic stepwise regression analysis. Results 32 of 437 patients (7.3% ) suffered from stroke after OPCABG, 32 cases were cerebral infarction and no case was cerebral hemorrhage. There were more patients whose left ventricular ejection fraction ≤0. 50 in stroke group than that in non-stroke group (12 of 32, 37.5% versus 69 of 405, 17.0% , P = 0. 004), more patients had atrial fibrillation after operation in stroke group than that in non-stroke group (9 of 32, 28. 1% versus 27 of 405,6.7% , P ＜ 0.001), more patients had hypotension after operation in stroke group than that in non-stroke group (13 of 32,40.6% versus 42 of 405, 10. 4% ; P ＜ 0. 001), more patients had ventilatory time and ICU time after operation in stroke group than that in non-stroke group(9 of 32, 28.1% versus 49 of 405, 12.1% , P =0.021; 14of 32,43.8% versus 97 of 405, 24.0% , P = 0.013), and patients in stroke group took longer to stay in hospital than that in non-stroke group (29.0 ±15. 8 versus 22. 9 ± 10. 4, P = 0. 002 ). Logistic stepwise regression analysis showed that left ventricular ejection fraction SS0.50(OR=2.837, 95%CI: 1.238-6.498), atrial fibrillation after operation( OR =3. 065, 95% CI: 1.157-8.118) and hypotension after operation (OR =4.209, 95%CI: 1.805 -9. 813) were independent risk factors of stroke following offpump coronary artery bypass grafting in patients with prior stroke. Conclusion This data suggest that left ventricular ejection fraction ≤0. 50, atrial fibrillation and hypotension after operation are risk factors for stroke following off-pump coronary artery bypass grafting in patients with prior stroke. These patients with stroke after operation took longer to extubate and stay in ICU and hospital.

Objective To explore the eorrelafion factors of health promotion lifestyle of the elderly los-ing their land and sea estate. Methods Using the health value scale, health promotion lifestyle profile and the general conditions scale to investigate the health value, health promotion lifestyle and general conditions of 85 old people losing their land and sea estate in Dalian development area. Results There was no correlation between health value and health promotion lifestyle of the eldly, age, education degree, number of children and previous employment were rehted with the health promotion lifestyle. Conclusions There was distance be-tween their thought and actual health behavior of the elderly, community management personnels and med-ical workers should strengthen the concrete intervention in lifestyle, not simply relying on propaganda of the importance of health.

Objective To assess the incidence, types and risk factors of atherothrombotic events (AT) within 7 days after transient ischemic attack (TIA) with ABCD2 Score in Chinese patients. Methods With ABCD2 Score, we retrospectively reviewed the medical records of 198 TIA patients ,which met the inclusion criteria of our study. They were divided into a low risk group (ABCD2 ≤3) and a moderate-high risk group(ABCD2≥4) and the incidence, types and risk factors of AT within 7 days after TIA were evaluated and compared respectively with χ2 test between the two groups. Statistic significance was considered as P < 0.05. Results The order of the frequency of accompanying diseases was hypertension 68.18% (135/198), diabetes 23.74% (47/198), coronary artery disease 21.72% (43/198), ischemic stroke 15.66% (31/198) and hyperlipemia 12. 63% (25/198). AT within 7 days after TIA was observed in 6.19% (6/97) of the patients in the low risk group, all of them were suffering from TIA recurrence. In the moderate-high risk group, 14. 85% (15/101) of the patients experienced AT, including 2 eases of TIA recurrence, 10 cases of ischemic stroke, 1 case of both TIA recurrence and ischemic stroke, 1 case of angina pectoris and 1 case of myocardial infarction. There was no peripheral vascular disease or death from vascular disease. Incidence of AT within 7 days in the moderate-high risk group was significantly higher than that in the low risk group (51.70% vs 27. 27%, P < 0.05). Conclusion TIA patients with ABCD2 ≥4 are at higher risk of AT within 7 days after TIA onset.

Objectives　To investigate the relationship between homocysteine (Hcy), folic acid, vitamin B12(VitB12),lipids and the carotid artery atherosclerosis(CAAs) and the significance of their levels in predicting cardiac and cerebral vascular events of older patients. Methods　Both sides of the common carotid artery and internal carotid artery were measured by B-mode ultrasound in 74 examinees in A, B, C, and D groups and a control group. With fasting serum, cholesterol, triglyceriade, apolipoprotein AI(Apo AI), apolipoprotein B (Apo B), lipoprotein (a) ［Lp(a)］, creatinine, glucose, folic acid, Vit B12 and Hcy were detected. Results　When carotid artery atherosclerosis became severer, serum Hcy was higher. The levels of the control and A, B, C, D groups were (10.2±3.6) μmol/L, (11.5±4.4) μmol/L, (17.9±4.5) μmol/L, (24.7±10.3) μmol/L, and (41.4±22.3) μmol/L respectively. SNK test showed a significant difference between D and other groups (P>0.05). Folic acid and Vit B12 were negatively correlated with the severity of carotid artery atherosclerosis, but only A and D groups showed statistical significance. Spearman correlation coefficient showed that serum Hcy had significant negative correlation with folic acid and Apo AI(P=0.035 and P=0.000).Multiple linear regression analysis between CAAs and various risk factors showed Apo AI had negative correlation, but Apo B, Lp(a) and Hcy had positive correlation with CAAs, especially Hcy(P=0.009).Conclusion　Hyperhomocysteinaemia is an important risk factor of artery atherosclerosis and the degree of CAAs is highly correlated with Hcy concentration. Hcy, Apo AⅠ,Apo B, Lp(a) are sensitive and reliable indexes for evaluating and predicting CAAs.