Objective To investigate the relationship between preoperative albumin level and postoperative acute kidney injury(AKI)following off-pump coronary artery bypass(OPCAB)surgery;to confirm albumin cut-off value associated with AKI. Method This was a retrospective cohort study. data from patients who accepted OPCAB surgery in last two years in our hospital and AKI was diagnosed according to KIDGO-AKI criteria. Results Generalized additive model and multivariable logistic regression analysis have shown that the higher preoperative albumin level is related with the lower the incidence of AKI after OPCAB surgery. By generalized additive model,multivariable logistic regression analysis and ROC curve,we confirmed the albumin cut-off value associated with AKI between 39~40 g/L. Conclusion For patients undergoing OPCAB surgery,the higher preoperative albumin level ,the lower the incidence of AKI. In order to reduce the incidence of AKI in OPCAB surgery patients,preoperative albumin level higher than 40 g/L should be maintained.

10.3969/j.issn.1008-9691.2013.03.003

Objective To investigate the role of nerve growth factor (NGF) in the pathogenesis of diabetic neuropathy (DNP) and the correlation of NGF level with,sensory nerve conduction velocity (SNCV) and duration of DNP.MethodsThe 41 patients with DNP,35 diabetics without DNP and 33 healthy controls were enrolled.And the serum level of NGF was measured with ELISA,the SNCV of left medial nerve,ulnar nerve,peroneal nerve and tibial nerve were measured too. Then the correlation analysis was completed. ResultsThe serum level of NGF was significantly lower in DNP patients [(665.18±188.32) ng/L] than in healthy controls [(976.44±159.07)ng/L] and in diabetics without DNP [(943.32±167.33) ng/L,F=9.316,P<0.001].The NGF level of DNP patients was positively correlated with SNCV of left medial nerve (r=0.810,P<0.001 ),left peroneal nerve (r=0.760,P<0.001) and duration of DNP (r=0.542,P<0.001).Conclusions The serum level of NGF is lower in DNP patients than in healthy controls.The decrease of the production of NGF may play a role in the pathogenesis of DNP.

Objective: To investigate the clinical effect of combination therapy on ankylosing spondylitis. Methods: 160 Cases were divided into treatment group and control group randomly. The patients of treatment group were given Bushenqingdu Decoction and Hanbiwaiyongfang by external use. The patients of control group were given Wangbi Granule. The symptoms and signs were observed before and after treatment in both groups. Results: There was significant difference between treatment group and control group in total effective rate as well as morning stiffness and signs (P

Objective To study the effects of embryonic neural stem cells transplantion on trauma of red nucleus neu-rons of the rats with spinal cord injury.Methods NSCs in logarithmic phage were labeled with BrdU,a Sprague Dawley rat mode of spinal cord injury (SCI) was developed with electrocircuit control spinal cord injuring device.Thirty SD rats were randomly divided into three groups: sham group,SCI group and NSC group.The NSCs were trans-planted into injured site three days after SCI.Then NSCs labeled with Brdu were detected by immunohistochemisty,rubrospinal tract (RST) neurons were labeled by retrograde transport of the horseradish peroxidase (HRP) from the lesion site,which were taken by damaged axons and remained in the neurons,then the labeled red nucleus (RN) neurons were counted.Hind limb function of experimental rats was evaluated by a blinder observer using BBB open field locomotion rating score.Results BrdU positive NSCs were detected in the spinal cord after transplantation,the number of RST neurons labeled by HRP in NSC group was more than that in SCI group (P <0.01),the BBB score of NSC group was higher than SCI group (P <0.01).Conclusion The transplanted NSCs can survive in the injured site of spinal cord and protect RN,then promote more remarkably functional recovery after SCI.

Chaihu Injection (CI), which is widely used in treatment of febrile diseases, is an aqueous solution of Chaihu (Radix Bupleuri Chinensis) or Nanchaihu (Radix Bupleuri Scorzonerifolii) prepared by steam distillation.

Objective To evaluate the viability of residual tumor after insufficient thermal ablation of rabbit VX2 liver tumor and investigated the efficacy of sorafenib as an adjuvant therapy.Methods Twenty-one rabbits were implanted with VX2 tumor to establish orthotopic liver tumor models.They were allocated randomly into 3 groups:control (n =7),ablation (n =7),and combination treatment (n =7).Microwave coagulation therapy was conducted with 20 W for 1 min and viable tumor tissue remained at the periphery.A laparotomy was performed in the control group.Sorafenib was given at 20 mg/kg/d during the following 10 days in the combination treatment group,and saline was given to the control and ablation group.Tumor volume was recorded before and after treatment,immunohistochemistry detected CD31 and proliferating cell nuclear antigen (PCNA) expression,and the micro-vessel density (MVD) and proliferation index (PI) were calculated accordingly.Results Ten days after insufficient ablation,tumor volume of the ablation group was larger than that of the control group (P ＜0.05).The MVD and PI of residual tumor were higher compared with those of the control group (P ＜ 0.05).With adjuvant therapy of sorafenib after insufficient ablation,tumor volume showed a decrease on the 10th day compared with tumors undergoing insurfficient ablation alone (P ＜ 0.05).The MVD and PI of residual tumor were lower than those of the ablation group (P ＜0.05).Conclusion Insufficient thermal ablation promotes residual tumor progression,but adjuvant therapy of sorafenib serves as an effective way to suppress the overgrowth and neovasculation of the residual tumor.

Objective To investigate the clinical characteristics of aerophagia in children,and to evaluate the effect of 24 hours esophageal multichannel intraluminal impedance monitoring in diagnosis of aerophagia.Methods The clinical data of 30 children with aerophagia hospitalized in Department of Digestive Disease,Nanjing Children's Hospital Affiliated to Nanjing Medical University from July 2005 to June 2013 were reviewed.The 24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases of aerophagia.The treatment of these patients normally included psychological counseling,dietary adjustment,Iactulose,Domperidone and vitamins,while Simethicone was given to the patients if normal treatment was invalid.Results Of the 30 patients,aged 2 to 13 years,averaged (8.6 ± 4.5) years,the chief complaints were abdominal distention in 30 cases (100.00％),visible or audible air swallowing in 28 cases (93.33％),repetitive belching in 27 cases (90.00％),reduced appetite in 25 cases (83.33％),constipation in 22 cases (73.33％),psychological stresses in 15 cases (50.00％),recurrent abdominal pain syndrome in 10 cases(33.33％),chronic diarrhea in 3 cases(10.00％) and acute abdominal pain in 3 cases(10.00％).Among the 30 patients,24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases,averaging 149.63 (47-553)times of air swallowing were recorded.In the 30 patients,24 cases (80.00％) were relieved after being treated with psychological counseling,dietary adjustment,lactulose,domperidone and vitamins,and only 6 cases(20.00％) were invalid for normal treatment but well responeded to Simethicone.Conclusions Aerophagia is a kind of functional gastrointestinal disorders in children.Abdominal distention,air swallowing,repetitive belching,reduced appetite,constipation and pain are common symptoms.It can be cured through psychological counseling management,diet modification,laxatives,propulsives and vitamins.24 hours esophageal multichannel intraluminal impedance monitoring is a useful technology in the diagnosis of aerophagia children.

OBJECTIVE To investigate the surgical approaches for maxillary sinus cyst. METHODS A total of 32 patients with maxillary sinus cyst underwent operation for removal the cysts. Among them, 8 patients with maxillary sinus cyst and sinusitis were operated on through Messerklinger approach, 19 patients with maxillary cyst received modified Caldwell-Luc operation under nasal endoscope and 5 patients received endoscopic removal of maxillary cyst through the maxillary sinus antrostomy at the inferior nasal meatus. RESULTS All the patients were followed up for 6 months to one year. There was no recurrence found in patients received modified Caldwell-Luc operation. There were 2 patients recurred in 8 patients who were operated on through Messerklinger approach and one patient had closure of the maxillary sinus ostium and adhesion of nasal cavity. One patient recurred and 2 lost follow up in 5 patients who received endoscopic removal of maxillary cyst through the maxillary sinus antrostomy at the inferior nasal meatus. CONCLUSION The optimal surgical method for maxillary cyst is modified Caldwell-Luc operation under nasal endoscope. Messerklinger technique may suitable for patients with complicated sinusitis.

AIM: The purpose of this study was to investigate the effects of rhBMP-2/collagen composite on bone regeneration during expansion of the interparietal suture in the rats. METHODS: 32 10-week old SD rats were divided into groups consisting of 8 rats each. They were comprised of normal control group, expansion control group and the treatment group, the two treatment groups were covered with atelo-typeⅠcollagen and rhBMP-2/collagen composite on the suture before subjected to the expansion force. The bone regeneration in the interparietal suture was estimated by histological method, the osteocalcin content was measured by radioimmonoassay and the calcium content was determined by atomic absorption spectrophotometer. RESULTS: The bone regeneration was more active in the suture after giving an expanding force than in the suture without any intervention. Even bone bridge was formed in the rhBMP-2/collagen composite group. Both the osteocalcin content and calcium content were much higher in the rhBMP-2/collagen composite group than in other three groups (P