Objective To evaluate clinical results of endoscopic vein harvesting(EVH) in patients who underwent coronary artery bypass grafting(CABG).Methods From July 2013 to October 2014,500 patients who underwent isolate CABG in our institution were divided into two groups:EVH group (n =250) and open vein harvesting(OVH) group(n =250).The surgical result and perioperative complications were compared between the two groups.Results The procedures were completed successfully in all the patients in both groups.There was no significant difference existed in the length of the harvested vein and vein injury between the two groups(P ＞ 0.05).Similar results were obtained in the in-hospital mortality.Compared to group OVH,group EVH showed significantly shorter harvesting time,smaller incision,and lower rates of perioperative leg complications (P ＜ 0.01).Group EVH had a less bed staying time after operation and a shorter post-operation hospital stay (P ＜ 0.05).EVH group achieved an improved patient satisfaction and postoperative pain when compared with OVH in CABG(P ＜0.05).Conclusion EVH can provide adequate vein graft for CABG,and also significantly reduce wound related complications when compared with OVH.EVH is recommended for vein harvesting to improve patient satisfaction.

Two-way choice is the main way for the seven-year-program clinical medical students and postgraduate supervisors.This article analyzes the influence factors and shortages of two-way choice for postgraduate supervisors and seven-year-program clinical medical students.This investigation discovers that the supervisor's abilities of research,teaching and clinical and their personal magnetism are important and key factors.The students' gender,character,hobbies and interests and the familiarity to profession are the secondary factors.The other factors that include employment status,the level of income and the advice of parents and friends also have influence on two-way choice for postgraduate supervisors and seven-year-program clinical medical students.In order to further improve the tow-way choice,the author gives some suggestions,including introducing profession and the scientific researches of supervisors in advance,encouraging the face-to-face communication between students and supervisors,promoting multiple profession choices and giving some aids to the students for choosing the supervisors.

Objective Toinvestigatetheeffectoffolicacidonplasmahomocysteine(Hcy)levels and vascular endothelial function in elderly cerebral infarction patients with hyperhomocysteinemia. Methods Thisstudywasaprospectivecontrolledtrial.Atotalof112elderlylacunarinfarction patients with high hyperhomocysteinemia admitted to the Department of Neurology,Nanjing Municipal Government Hospital from November 2012 to October 2013 were enrolled. The patients were divided into two groups according to the method of random number table. The patients of both groups received the conventional drug treatment of ischemic stroke at the same time. Fifty-six patients were in group A,and they were treated with folic acid 20 mg,once a day;56 patients were in group B,and they did not treat with folic acid. The Hcy levels on admission and after 24 weeks treatment were measured. Brachial artery flow-mediated endothelium-dependent dilation (FMD)was measured by high resolution ultrasound,and nitric oxide (NO), nitricoxidesynthase(NOS),andendothelin(ET)weredetectedatthesametime.Results Twenty-four weeks after treatment,the plasma Hcy level in group A was significantly decreased as compared with prior treatment (12. 2 ± 4. 2 vs. 22. 6 ± 3. 7μmol/L;P<0. 05),moreover,it was lower than the level of group B at the same period (12. 2 ± 4. 2 vs. 21. 8 ± 4. 0μmol/L;P <0. 05 ). The FMD level of group A was significantly higher than that of prior treatment and group B (11. 2 ± 3. 6 vs. 9. 2 ± 3. 3,9. 3 ± 3. 3;P<0. 05). The NO and NOS levels of group A at 24 weeks after treatment were significantly higher than those of prior treatment and group B at the same period (76. 2 ± 9. 4 vs. 49. 2 ± 9. 0,50. 0 ± 9. 1μmol/L,47. 6 ± 9. 5 vs.38. 4 ± 7. 5,37. 8 ± 8. 8 kU/L;P<0.05). The ET level of group A was decreased as compared with that of prior treatment and group B at the same period (81. 3 ± 20. 5 vs. 105. 6 ± 25. 2,105. 3 ± 21. 8 ng/L;P<0.05).NoadversereactionwasfoundduringthetreatmentingroupA.Conclusion Alargerdoseof folic acid can significantly reduce the plasma Hcy level,decrease the FMD level,and ameliorate vascular endothelial function in elderly cerebral infarction patients with hyperhomocysteinemia.

Objective To explore the role of leptin,COX-2 and p27 in bile-induced gastric mucosal injury in rats.Methods SD rats were divided into 4 groups: DGR(duodenogastric reflux) group,DGR+BDL(ligation of bile duct) group,BDL group and control group.The pathological changes of gastric mucosa and tight junction were observed,DIXON scores were warked out after 3 months.Immunohistochemistry was used to detect the expression of leptin,COX-2 and p27 in gastric mucosa with different lesions. Results The DIXON scores in DGR and DGR+BDL group were higher than those in BDL group and control group(P

Cotinine is the best biomarker for the assessment of the exposure to environmental tobacco smoke(ETS).With the"Framework Convention on Tobacco Control"implemented in China,the hazards from ETS are increasingly concerned,the determination of cotinine in human body which reflects the internal exposure to ETS received universal recognition day by day.It is imperative to create a standardized,simple and fast method to detect cotinine in human body.The recent determination techniques of cotinine,the application in different human samples and the direction of development were introduced in the present paper.

OBJECTIVE:To observe the efficacy and safety of vitamin A acid combined with vitamin A,vitamin E,celecoxib in the treatment of oral leukoplakia. METHODS:104 patients with oral leukoplakia were randomly divided into control group(52 cases) and observation group (52 cases). Control group received 1 Vitamin A soft capsule,3 times a day+1 Vitamin E soft cap-sule,3 times a day+1 Celecoxib capsule,twice a day. Observation group additionally received 1 Vitamin A acid tablet,twice a day. 4-week was regarded as 1 treatment course,it lasted for 3 courses. Clinical efficacy,and leukoplakia number,maximum diam-eter of leukoplakia,immunoglobulin A(IgA),IgM,IgG before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the dif-ference was statistically significant(P<0.05). Before treatment,there were no significant differences in leukoplakia number,maxi-mum diameter of leukoplakia,immunoglobulin levels in 2 groups(P>0.05). After treatment,leukoplakia number,maximum diam-eter of leukoplakia,IgA and IgM in 2 groups were significantly lower than before,and observation group was lower than control group,IgG was significantly higher than before,and observation group was higher than control group,the differences were statisti-cally significant (P<0.05). And there was no significant difference in the incidence of adverse reactions in 2 groups (P>0.05). CONCLUSIONS:Vitamin A acid combined with vitamin A,vitamin E,celecoxib shows obvious efficacy in the treatment of oral leukoplakia,it can effectively reduce clinical symptoms,improve immune function,with good safety.

The concrete methods and experiences for foreign students in case study in the past decades were introduced in this article. We emphasized on teaching students in accordance with their aptitude and step by step, explaining the profound things in a simple way and giving attention to different students' capabilities during teaching. In the practice, we surely felt that case study will bring more advantage than traditional teaching methods, motivate students and improve the capabilities to understand the course content.

Animals ; Blood Glucose ; Cucurbita ; chemistry ; Diabetes Mellitus, Experimental ; drug therapy ; Hypoglycemic Agents ; pharmacology ; Lipids ; blood ; Oxidative Stress ; Polysaccharides ; pharmacology ; Rats

Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; methods

Objective To learn the change of serum thymidine Kinase 1(TK1) level in the treatment process of the early cure nasopharyngeal carcinoma patients and its relationship to pathological features .Methods From January 2010 to December 2013 ,35 cases of nasopharyngeal carcinoma patients were collected into our study ,20 cases of nasopharyngeal inflammation patients were chosen as the control .Serum TK1 level in the 2 groups was compared before and after treatment .Results TK1 in control group had no significant differences before and after treatment (P>0 .05) .Compared with the control group ,serum TK1 in nasopharyngeal carcinoma group were higher before and after radiotherapy (P<0 .05);after radiotherapy ,serums TK1 in nasopharyngeal carcinoma group were lower(P<0 .05) .Before and after radiotherapy ,serum TK1 Ⅰ and Ⅱ stage were lower than in Ⅲ and Ⅳ stager(P<0 .05) ,lymph node metastasis group were higher than no lymph node metastasisr (P<0 .05) ,TK1 had higher expression in TNMⅣ than TNM Ⅱ(P<0 .05) ,compared with lymph node metastasis and cervical nerve violated groups ,TK1 expression was higher in none lymph node metastasis and none cervical nerve violated groups (P<0 .05) .Conclusion TK1 can reflect the tumor load and proliferative activity of nasopharyngeal carcinoma ,which could be as a factor in nasopharyngeal carcinoma diagnosis ,monitoring and prognosis .