Objective To study a minimally invasive surgical procedure for coronary artery bypass grafting (GABG). Methods 23 patients, aged from 45 to 73 years old, undervent off-pump coronary artery bypass grafting (OPCABG) according to Octopus procedure from December 1999 to Auguest 2001. In the present study , more than 3 vessels were involved in 19 patients; 2 vessels involved in 3 cases and 1 vessel involved in one case. The grafted arteries included left anterior descending branch (LAD)(23); circumflex(CX)(15); right coronary artery(RCA)(14); ramus intermedius(RUM)(8); and posterior descending artery(PDA) (8). The types of grafts were left internal mammary artery (LIMA)(20) and saphenous vein grafts(SVG)(48). Results None of the patients was managed by means of cardiopulmonary bypass. All survived without angina pectoris. MRI showed that all the conduits were patent postoperatively. Conclusions OPCABG by Octopus procedure can be used in multiple vessel coronary bypass including CX and PDA. The patency rate is similar to that of the conventional technique. The mortality rate and occurrence of complications is low compared with those of the conventional technique . In addition, medical cost is lower. So This procedure is both safe and cost-effective, and is of value in clinical practice.

Objective To study the relationship between quality of life and social support and ex-plore effective ways to improve quality of life in patients with cardiomyopathy. Methods In-hospital pa- tients (50 cases) with eardiomyopathy were randomly selected and inquired by applying general quality life inventory(GQOLI-74) and social support rating seale(SSRS),compared with 45 normal people as the con- trol group. Results Compared with the control group, quality of llfe (P < 0.05) and social support (P <0.01 ) in patients with eardiomyopathy decreased significantly.Social support was positively related with quality of life (r =0.614, P < 0.01 ). Conclusions Quality of life is closly related with social support in patients with cardiomyopathy. Improving quality of life by social support in patients with cardiomyopathy should be emphasized and make effective use of in the courses of nursing.

Objective To build of lentiviral mediated RNA interference of mammalian target of rapamcin (mTOR) ,because the mammalian target of rapamycin plays a important role in tumor development and the signal path .Methods According to RNA in-terference (RNAi) design rules Completely ,in view of the gene called mTOR was desiged four interference targets and Negative control (FAM ) sequence ,first of all ,synthetic oligonucleotides nucleotide fragments with artificial ,and can obtain siRNA fragments effectively by the method of PCR joining together ,then undertake transfection on lung adenocarcinoma A 549 cell by Lipofectamine transfection reagent 2000 .To begin to observe the enhanced green fluorescent protein expression in lung adenocarcinoma A 549 cells by fluorescence microscopy at high magnification after 1 days .We can use semi-quantitative RT-PCR method ,and detect of mTOR gene expression of mRNA level after 1 days ,meanwhile ,testing the expression of protein levels by Western Blot after 2 days ,in or-der to select the most efficient interference target sequence ,,afterwards ,synthetic double-stranded DNA ,and it can be make up vec-tor system with plasmid pHelper 1 .0 and pHelper 2 .0 by the pGCL-GFP carrier ,further transfect 293 T cells ,at last produce lenti-viral after packaging ,then detection GFP protein expression levels by Western-Blot method ,and consequently detect the virus drops degree of 293T cells ,at the same time ,identify the activity .Results The high efficiently target of mTOR gene has been successfully selected ;mTOR siRNA infecte of human lung adenocarcinoma A549 cells in vitro culture ,and the gene is obviously silence no mat-ter from the mRNA level or protein level ;3 mTOR gene lentivirus siRNA carrier was successfully build .geting virus supernatant al-so ,and virus drops to 1 × 108 UT/mL .Conclusion MTOR siRNA infected of human lung adenocarcinoma A549 cells in vitro cul-ture ,and could lead to mTOR gene obviously silence ;The construction was successfully gene mTOR siRNA lentivirus vectors .

OBJECTIVE To comprehend antimicrobial susceptibility distribution of the ?-lactamases products from Feb 2002 to Feb 2003 in our hospital.METHODS The Microscan-USA was used to identify pathogens and drug sensitivity tests,the results of examination were judged according to NCCLS 1999 standard.(RESULTS) Among the isolated 67 strains of ESBLs-producing bacteria(35.64%),31 strains of(Klebsiella) pneumoniae(36.05%),29 strains of Escherichia coli(43.28%), 6 strains of Enterobacter cloacae((22.22)%)and 1 of K.oxytoca(12.5%) were detected.The multi-resistance of ESBLs~+ bacteria was very usual,besides to the ?-lactam antibiotics.The pattern of being resistant to both of tobramycin and ciprofloxacin was relatively common,and amikacin was relatively less,even the complex antibiotics containing ?-lactamases inhibitor would lose their effect.(CONCLUSIONS)The ESBLs bacteria exist in our area at a high level and also be the main antimicrobial-resistant ones and have got the resistance to many kinds of antibiotics.To control the(ESBLs)~+(bacteria) infection,expanding and supervision management of antibiotics is a urged task and important for us.

OBJECTIVE To analyze the high incision infection rate in abdominal operation in order to take effective preventive measures.METHODS Totally 2302 cases of abdominal operation in general surgery were investigated retrospectively from Jan 2005 to May 2007.The diagnosis standard was based on the Diagnosis Standard of Hospital Infection(Draft) published by Ministry of Health of the People′s Republic of China in Jan 2001.RESULTS From them 113 cases suffered incision infection.The infection rate was 4.85%,accounted for 81.54% of all surgical operation incision infections.The pathogenic bacteria in the samples taken during the operation were the same as those in the secretion of postoperative incision in terms of species and source.CONCLUSIONS The key points of prevention of incision infection are sterile operation,flushing of abdominal cavity and enhanced detection of environment hygiene in operating room.The infection rate could be lowered through observation and nursing care of postoperative incision and proper use of antibiotics.

OBJECTIVE To strengthen the hospital infection management in community health service centers,in order to reduce the onset of hospital infection.METHODS According to Hospital infection administration regnltions and Shenzhen medical service hospital infection control quality evaluation management demands we had investigated and evaluated the hospital infection management in 9 community health service centers.RESULTS The monitoring,surveillance and management of hospital infection in community health service centers as a quality evaluation index of hospital medical service still had many problems,it should further enhance the quality in the field of administration management,sterilization and disinfection,surveillance and sevage treatment.CONCLUSIONS The hospital infection management in community health service centers is a part of whole hospital medical service,but their quality at present is weak.To strengthen the hospital infection management is important to guarantee the medical service quality and medical care safety.

Objective: To compare the effects of ultra-fast track anesthesia and traditional anesthesia on blood levels of high sensitivity C-reactive protein (Hs-CRP), C-reactive protein (CRP) and procalcitonin (PCT) in patients after pediatric cardiac surgery.
Methods: A total of 101 patients received pediatric cardiovascular surgery by a same anesthesiologist in our hospital from 2013-09 to 2014-05 were retrospectively reviewed. The patients were studied in 2 anesthesia groups:Ultra-fast track group, in which the extubation was conducted in operating room, n=40 and Traditional group, n=44. Blood levels of Hs-CRP, CRP and PCT at pre-operation (T0), 1st day post-operation (T1) and 2nd day post-operation (T2) were compared.
Results: ①Hs-CRP levels were higher at T1 and T2 than T0 in both groups, all P<0.05;Hs-CRP level in Ultra-fast track group was lower than Traditional group at T1 time point, P<0.05. ②CRP levels were similar among 3 time points in Ultra-fast track group;while in Traditional group, CRP level at T2 was higher than T1, P<0.05; CRP level was higher in Traditional group than Ultra-fast track group at T2, P<0.05.③PCT levels at 3 time points were similar in the same group;while PCT level in Ultra-fast track group was lower than Traditional group at T1 time point, P<0.05.
Conclusion: Compared With traditional anesthesia, ultra-fast track anesthesia could decrease the post-operative elevations of Hs-CRP, CRP and PCT in patients after pediatric cardiac surgery.

Objective: Compared with ketamine anesthesia, to investigate sevoflurane inhalation combining laryngeal mask airway for anesthesia induction in pediatric cardiac surgery.
Methods:A total of 40 pediatric patients with congenital heart diseases received elective cardiac surgery in our hospital from 2013-08 to 2014-01 were studied. The children were from 6 months to 2 years of age and randomly divided into 2 groups, n=20 in each group. Sevolfurane group, the children inhaled the mixture of 8%sevolfurane and 100%O2, laryngeal mask airway was used upon losing consciousness for mechanical ventilation, the anesthesia was maintained by (3-4)% sevolfurane inhalation to facilitate central venous catheter placement. Ketamine group, the children received intramuscular injection of ketamine (7 mg/kg)+atropine (0.01 mg/kg). The peripheral venous line was established upon losing consciousness, the intravenous midazolam (0.1 mg/kg), pipecuronium (0.10 mg/kg), fentanyl (5 μg/kg) were applied, then tracheal intubation was performed for mechanical ventilation and the anesthesia was maintained by (0.5-1)%sevolfurane to facilitate central venous catheter placement.
Results: Sevoflurane group had the shorter time for losing the consciousness than that in Ketamine group (48.90 ± 3.93) s vs (577.85 ± 116.41) s, P<0.05 and the shorter time for ifnishing the central venous catheter placement (11.15 ± 2.48) min vs (24.15 ± 4.02) min, P<0.05. The average blood pressure and heart rate were similar between 2 groups after laryngeal mask or tracheal intubation, P>0.05. The arterial PH value, PaCO2, BE and lactatein were similar between 2 groups, P>0.05.
Conclusion: Sevoflurane inhalation combining laryngeal mask airway could shortening anesthesia preparation time with simple management. It provided an important anesthesia option in pediatric cardiac surgery.

OBJECTIVE:To observe the bleeding,therapeutic efficacy and ADR of patients with acute cerebral infarction (ACI) treated by alteplase intravenous thrombolysis. METHODS:140 ACI patients were randomly divided into group A and B with 70 cases in each group. Group A was give alteplase 0.6 mg/kg for intravenous thrombolytic therapy,and group B was given al-teplase 0.9 mg/kg for intravenous thrombolytic therapy. The bleeding after thrombolysis,bleeding time,therapeutic efficacy and ADR were compared between 2 groups. RESULTS:The incidence of Subcutaneous ecchymosis,gingival bleeding,bleeding of di-gestive tract and intracranial hemorrhage of group A were 4.29%,2.86%,2.86% and 2.86%;those of group B were 14.29%, 12.86%,11.43% and 11.43%;the bleeding time of those symptomsin 2 groups were(6.04±0.75)and(7.22±0.56)h、(24.63± 10.24)and(35.22±9.87)min、(3.04±0.11)and(4.08±0.25)h、(3.12±0.48)和(4.53±0.66)h respectirely,with statistical signifi-cance(P<0.05). There was no statistical significance in therapeutic efficacy and ADR between 2 groups after treatment(P>0.05). CONCLUSIONS:The bleeding should be monitored strictly when ACI patients receive alteplase intravenous thrombolysis,and low-dose alteplase thrombolysis can ultimately reduce the incidence of bleeding.

Objective To investigate the prevalence of metabolic syndrome (MS) among adults in rural areas of Ningxia Hui autonomous region.Methods A cross-sectional study was conducted in 10 639 adults enrolled with a multistage method from Jingyuan County.The MS was identified according to Chinese type 2 diabetes prevention guide (2013).Results Among all the subjects, 17.4% of them met the MS definition with the standardized prevalence of 14.7% after adjustment of sex and age.The prevalence and standardized rate of MS in men were 19.9% and 17.3%, and in women were 15.3% and 13.5%.The prevalence of MS in men was higher than that in women(P<0.001) and increased with aging in both genders.The prevalence and standardized rate of abdominal obesity,hyperglycemia,hypertension,high triglycerides,and low HDL-C were 19.5% and 16.7%, 15.0% and 12.9%, 42.0% and 37.1%, 25.8% and 23.1%, 28.5% and 27.7%,respectively.The rate of abdominal obesity was higher in women than in men (20.5% vs 18.2%, P=0.004), whereas the rate of hypertension, high triglycerides, and low HDL-C were higher in men than in women (all P<0.01).The prevalence of having one parameter of the MS was 68.4%.Conclusion The prevalence of MS is higher in rural areas of Ningxia Hui autonomous region, suggesting that a series of comprehensive prevention measures should be carried out to prevent and control the MS so as to improve the public health conditions in rural areas.