5) receiving cardiopulmonary coronary artery bypass grafting(CCAB) during the same period was reviewed as control group(CCAB Group).The preoperative risk factors,operation parameters,and postoperative outcomes between the two groups were compared for statistical analysis.Results The EuroSCORE value of the OPCAB Group and the CCAB Group was 9.0?2.6 and 8.3?2.1,respectively(t=2.016,P=0.045). The number of grafts in the OPCAB Group was less than that in the CCAB Group(3.2?0.9 vs 3.8?0.9;t=-4.267,P=0.000).The postoperative levels of creatine kinase(CK) and creatine kinase myocardial band(CK-MB) were significantly lower in the OPCAB Group [570(61～8246) U/L and 20(1～282) U/L] than the CCAB Group [870(246～8155) U/L and 55(12～300) U/L](Z=-3.648 and-5.767,P=0.000).The blood transfusion in the OPCAB Group was significantly less than that in the CCAB Group(775?693 ml vs 1088?712 ml;t=-2.887,P=0.004).There was no statistical difference in postoperative complications between the two groups.The mortality is 3.5%(4/113) in the OPCAB Group and 6.6%(5/76) in the CCAB Group,without statistical difference(?2=0.925,P=0.336).Conclusions OPCAB is safe and effective in high risk patients.Different operation methods should be used for patients with different risks.

0.05]. Moreover, the Qm and PI of the grafted anterior descending, circumflex, and right coronary arteries were similar between the two groups.Conclusions No significant difference exists in the graft blood flow between OPCABG and CCABG groups.

Objective To evaluate the clinical value of liquid-based thinprep cytology test (TCT) and human papillomavirus (HPV) in cervical lesions diagnosis.Methods 525 patients with TCT was inflammation and abnormalities had HPV testing and colposcopy with biopsy analysis.Results Histopathological diagnosis as CIN Ⅰ or CIN Ⅰ above cases percentage of TCT of ASCUS,LSIL,HSIL,and cancer cases were 55 ％ (160/290),88 ％ (99/113),92 ％ (24/26) and 100 ％ (4/4),Pathological diagnosis as inflammation and glandular phosphate in 441 cases of this TCT-positive patients were 148 patients,false positive 34 ％.TCT-negative patients,pathologically confirmed of CIN in 84 cases patients with moderate to severe cervical erosion or cervical polyps were 22 cases,26 ％ TCT false negative.They had statistically significance (x2 =815.4,P =0.000).74 ％ HPV positive patients diagnosed as CIN Ⅰ or CIN Ⅰ above (x2 =104.94,P =0.000).Diagnosed as CIN Ⅰ cases in less than 30 years old accounted for 62 ％ (61/98),CIN Ⅱ and above for only 38 ％ (37/98) and without cancer.But the CIN Ⅰ in above 30 age group was significantly reduced to only 37 ％ (81/217),CIN Ⅱ and above was significantly increased to 63 ％ (136/217),and cancer rate increased (x2 =63.71,P =0.012).Histopathological diagnosed as CIN Ⅰ case were 26 ％ (83/315) of cervical smooth,74 ％ (232/315) of cervical erosion; 14 cases of cancer occurred in patients with cervical erosion.It was statistically significant (x2 =39.9,P =0.014).Conclusion TCT and HPV for screening of cervical lesions play an important role in cervical lesions screening.

HSP90, which is the biomarker of cell stress and endogenous protective protein, functions as a molecular chaperone. Many client proteins of HSP90, including EGFR, Met, Raf-1, IKK and p53, play important roles in the occurrence and development of tumor. Binding of HSP90 inhibitors triggers the deactivation of HSP90, resulting in client protein degradation, and hence inhibits the tumor growth by blocking multiple targets involved in signaling of tumor proliferation. This review summarizes recent development of small molecule inhibitors bound to N-terminal of HSP90.

Objective To investigate the clinical effect of maternal pat with Chinese medicine in episiotomy wound care. Methods One thousand one hundred cases of maternal with full-term,vaginal delivery, episiotomy in the Beijing Tongren Hospital Affiliated to Capital Medical University from Jun. 2013 to Jun. 2014 were randomly divided into test group and control group. Patients in test group were given routine nursing care combined with Chinese medicine maternal pat to nurse perineal wound,while in the control group were given routine nursing combined with common maternal pat. The data of perineal wound swelling,pain and healing were recorded and compared in two groups. Results The incidences of mild,moderated swelling within 24 h,48 h in test group were 35. 5%( 195/550 )and 6. 0%( 33/550 ),13. 4%( 74/550 )and 1. 6%( 9/550 ),significantly lower than that of the control group( 24 h:51. 5%( 283/550 ),24. 5%( 135/550 );48 h:34. 2%( 188/550 ), 2. 7%(15/550);Z=12. 555,8. 144;P﹤0. 01). The incidences of moderate,severe pain within 24 h,48 h in test group were 12. 5%(69/550)and 2. 9%(16/550),8. 4%(46/550)and 1. 3%(7/550),significantly lower than that of the control group( 24 h:37. 3%( 205/550 ),7. 5%( 41/550 );48 h:20. 6%( 113/550 ),3. 5%(19/550);Z=10. 429,11. 886;P ﹤0. 01). The wound healing rate in test group was 92. 36%,significantly higher than that of control group( 80. 73%,P ﹤0. 01 ). The wound infection rate in test group was 1. 82%, significant lower than that of control group(3. 82%,P﹤0. 01). The incidence of comfort and satisfaction in test group was 90. 18%,significantly higher than that of control group(73. 09%;Z= -5. 614,-7. 345;P ﹤0. 05). Conclusion Nursing lateral episiotomy wound using Chinese medicine maternal pat can reduce the swelling, pain and promote wound healing with convenient and comfortable. Therefore,it is worth of the clinical popularization and application.

Objective To compare the effect of four-in-one teaching method and traditional teaching method in clinical clerkship teaching in the department of obstetrics and gynecology. Methods Totally 70 clinical probationer were enrolled(35 from 2007 grade were taken as control group and 35 from 2008 grade were taken as experiment group ). Four-in-one teaching method and traditional teaching method were respectively in experiment group and control group. Examination score and clinical skill re-sults were analyzed by t test and satisfaction degree was analyzed byX2 test. P<0.05 signifies statistical sig-nificances . Results Examination score of experiment group and control group were 86 . 9 ± 7 . 7 and 76.5 ±8.7 respectively with statistically significant differences(P=0.000). Clinical skill score of experi-ment group and control group were 87.6±6.9 and 75.9±7.5 respectively with statistically significant dif-ferences(P=0.000). Each questionnaire index was significantly higher in experiment group than in con-trol group with statistically significant differences(P=0.000). Conclusions Four-in-one teaching method can make students understand theoretical knowledge and master obstetrics and gynecology basic clinical skills,enhance interests in learning,build up self-confidence and establish preliminary clinical thinking ability and innovation ability which will lay a solid foundation for future clinical and research practice.

Objective:To investigate the rate of compliance with sepsis Bundle and outcomes in patients with septic shock in intensive care units (ICU) in Changshu area.Methods:A multi-center retrospective study was conducted on patients who were diagnosed as septic shock in ICU of three hospitals in Changshu area from January 2014 to October 2017. Patients who were diagnosed as septic shock meeting the 2016 diagnostic criteria were enrolled. The exclusion criteria were paients younger than 18 years, pregnancy, death within 6 h of admission, halfway abandoned treatment, and those who had entered other studies on septic shock intervention. Clinical characteristics, past history, situation on admission, Bundle completion at 1 h, 3 h and 6 h, and prognosis were recorded. Patients were divided into the survival group and death groups according to whether they survived or not. The differences of completion of Bundle indicators between the two groups were compared. The independent risk factors of prognosis were analyzed by Logistic regression analysis, and the survival curve was plotted by Kaplan-Meier method.Results:Totally 207 patients from 3 hospitals were enrolled in this study. The complition rate of 1 h Bundle was 27.1%, of which the completion rate of serum lactate determination was 81.2%, the completion rate of blood culture before antibiotic administration was 72.5%, the completion rate of broad-spectrum antibiotic administration was 48.4%, the completion rate of fluid resuscitation was 74.4%, and the completion rate of vasopressors to maintain MAP≥65 mmHg was 86.0%; the completion rate of 3 h Bundle was 67.6%, of which the completion rate of serum lactate determination was 97.1%, the completion rate of blood culture before antibiotic administration was 84.5%, the completion rate of broad-spectrum antibiotic administration was 97.1%, and the completion rate of fluid resuscitation was 76.8%; the completion rate of 6 h Bundle was 30.4%, of which the completion rate of vasopressors to maintain MAP≥65 mmHg was 98.1%, the completion rate of reassessed volume stasis (at least two indexes) was 48.3%, the completion rate of central venous pressure (CVP) was 42.5%, the completion rate of ScvO 2 was 10.6%, the completion rate of bedside ultrasound was 48.8%, the completion rate of passive leg raising and rehydration therapy was 42.5%, and the completion rate of re-evaluation of lactate was 55.1%. The total Bundle completion rate at 3 h and 6 h was 27.1%. There was no significant difference in the completion of the three hospitals. The mortality of patients with septic shock was 58.9%, length of stay in the ICU was 10 d (5, 23) d, and length of hospital stay was 14 d (6, 26) d. Univariate analysis showed that antibiotic use time, CVP, bedside ultrasound, passive leg raising and rehydration experiments, re-evaluation after elevated lactate, 6 h Bundle completion, total Bundle completion at 3 and 6 h, and APACHE Ⅱ score were associated with the prognosis (all P<0.01). Logistic regression analysis showed that CVP ( OR=23.236, P=0.001), passive leg raising and rehydration experiments ( OR=0.102, P=0.012), re-evaluation after elevated lactate ( OR=0.197, P=0.001) and APACHEⅡ score ( OR=1.103, P<0.01) were risk factors of the prognosis. Kaplan-Meier analysis showed that the 28 d survival rate was significantly higher if 6 h Bundle was completed (Log Rank χ 2=8.944, P=0.003). Conclusions:The compliance with sepsis Bundle is not high in Changshu area, and the compliance is closely related to the prognosis, so it needs to improve compliance with the guidelines.

Objective:To investigate the efficacy of phenolamine in the treatment of sepsis-induced myocardial dysfunction and its effect on cardiac function, myocardial injury index, and hemodynamics in patients.Methods:The clinical data of 79 patients with sepsis-induced myocardial dysfunction who received treatment in Huangshi Central Hospital, Edong Healthcare Group from February 2017 to February 2020 were retrospectively analyzed. These patients were divided into a control group (without phenolamine treatment, n = 41) and an observation group (with phenolamine treatment, n = 38) according to whether they received phenolamine treatment or not. Clinical efficacy, cardiac function, myocardial injury index, and hemodynamic index pre- and post-treatment were compared between the two groups. Results:There was no significant difference in 28-day mortality rate between the two groups ( P > 0.05). Intensive care unit length of stay and mechanical ventilation duration in the observation group were (9.33 ± 3.52) days and 83.00 (28.50, 138.00) hours, which were significantly shorter than (12.17 ± 4.15) days and 111.00 (47.50, 169.00) hours in the control group ( t = 3.26, Z = -2.27, both P < 0.05). The response rate in the observation group was significantly higher than that in the control group [81.58% (31/38) vs. 60.98% (25/41), χ2 = 4.05, P < 0.05]. After 7 days of treatment, the left ventricular ejection fraction in each group was significantly increased, and the left ventricular end-diastolic diameter and left ventricular end-systolic diameter in each group were significantly decreased compared with before treatment (all P < 0.05). After 7 days of treatment, the left ventricular ejection fraction in the observation group was significantly higher than that in the control group ( t = 3.29, P < 0.05), and left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly lower than those in the control group ( t = 5.94, 11.21, both P < 0.05). N-terminal pro-brain natriuretic peptide and cardiac troponin I levels in each group were significantly decreased with time (both P < 0.05). At 24 and 72 hours and 7 days after treatment, N-terminal pro-brain natriuretic peptide and cardiac troponin I levels in the observation group were significantly lower than those in the control group (both P < 0.05). After 7 days of treatment, heart rate in each group decreased significantly compared with that before treatment (both P < 0.05), mean arterial pressure, cardiac index, and stroke output index in each group increased significantly compared with those before treatment (all P < 0.05). After 7 days of treatment, heart rate in the observation group was significantly lower than that in the control group ( t = 4.90, P < 0.05), and mean arterial pressure, cardiac index, and stroke output index in the observation group were significantly higher than those in the control group ( t = 4.37, 3.23, 6.01, all P < 0.05). Conclusion:Phentolamine can improve hemodynamics, reduce myocardial injury and improve cardiac function in patients with sepsis-induced myocardial dysfunction.