Objective To discuss the feasibility and safety of minimally invasive direct coronary artery bypass grafting (MIDCABG). Methods A total of 33 patients underwent small incision, off-pump, single-vessel direct coronary artery bypass grafting in this hospital from March 2001 to September 2003. Left anterior small thoracotomy was adopted in 14 patients, whereas partial midline sternotomy was conducted in 19 patients. The left internal mammary artery was anastomosed to the anterior descending artery in 31 patients, construction of the aorta root-anterior descending artery anastomosis using the great saphenous vein was carried out in 1 patient, and the right gastroepiploic artery was anastomosed to the posterior descending artery in 1 patient. Results The operative mortality was a zero. The intraoperative blood loss was 163?120 ml, and the postoperative drainage, 193?169 ml. The assisted respiration time after operation was 6 4?5 5 hours and the duration in ICU was 17 8?4 4 hours. Follow-up for 14 7?7 4 months found no deaths. Conclusions MIDCABG is a safe and reliable procedure, offering minimal invasion, less blood loss and fewer complications.

Since the first intein was found, more and more attenti on were paid on it. It not only enrichs the content of the process that the gene transfers its information but also can be used in protein purification. The rec ent advance in the sequence characteristic, transfer, evolution and the mechanis m of splicing of intein was summarized.

Objective To explore the effect of quality control circles (QCCs) in improving the delivery health checkup report.Methods QCC was founded with the theme of"improving the quality of health checkup report delivery."First,we planned an activity schedule and identified topics.We then set target focuses for service personnel,distribution modes,and operating environments;planned countermeasures;and selected optimal policies.Circle members implemented the optimal policies jointly.Reports of physical examinations by the Guoyu health management center were selected and analyzed.The total number of reports before improvement (January to December 2015) was 59 189 of which 34 549 (58.4％) were male patients and 24 640 (41.6％) were female patients;their average age was (37.7± 11.4) years.The total number of reports after improvement (December 2016 to January 2017) was 6 568,of which 3 881 (59.1％) were male patients and 2 687(40.9％) were female patients;their average age was (39.9± 11.7) years.We compared the quality indicators and evaluated the comprehensive quality of the patients before and after improvement.A total of 65 531 physical examination reports of subjects examined at the center between February and December 2017 were selected for effect tracking,including 39 230 (59.9％) men and 26 301(40.1％) women,aged (38.1±11.5).Results The on-time delivery rate of the health examination reports from rose from 51.4％ to 94.0％.The ratio of system leakage to sign for reports decreased from 14.5％ to 0.8％.The average time between the examination and when each report was handed over to for distribution decreased from 29.8 hours to 4.2 hours,and the average time between each report being distributed to the providers checking in dropped from 509.8 hours to 72.8 hours,while the average time for the preparation of each report for delivery decreased from 13.5 seconds to 3.1 seconds.The average time between delivery of a report and its being signed decreased from 4.3 seconds to 0.1 seconds.Before the improvement,the expected goals were not met.After improvement,the delivery rate of the health examination reports was 100.0％,the delivery intact rate of the group reports was 100.0％,and the satisfaction rate of the group reports was 99.4％.The comprehensive quality for the members was obviously higher after the improvement than before.After 11 months of tracking,the delivery accuracy rate of health examination report still failed to reach the target value of 100.0％,but all other indicators reached the target value,with good results.Conclusions Application of QCC not only improved the delivery the health checkup reports,but also promoted service quality after medical examinations and ended medical dispute caused by the loss of physical examination reports.