Objective To summarize clinical results of 29 cases of multi-vessel coronary disease treated by hybrid revascularization.Methods A total of 29 consecutive patients(all male,aged 62.8?9.7 years) with coronary artery disease(two-vessel,n=10;three-vessel,n=19) were treated with minimally invasive direct coronary artery bypass(MIDCAB)(left internal mammary artery to left anterior descending artery,LIMA-to-LAD) and percutaneous coronary intervention(PCI) between January 2000 and April 2005.The left ventricular ejection fraction(LVEF) was 0.576?0.108.Concomitant diseases included hypertension in 23 patients,insulin-dependent diabetes mellitus in 5 patients,chronic obstructive pulmonary disease in 2 patients,and old myocardial infarction in 14 patients.Results The 29 patients received 33 grafts(LIMA: 27 grafts;great saphenous vein: 6 grafts).Balloon angioplasty was carried out in 41 coronary lesions,usually following surgery.The mean number of revascularization was 2.5 per patient.There was no surgery-related complications and mortality.The blood flow in the LIMA was 45?14 ml/min.The chest drainage volume was 274?197 ml.Blood transfusion was required in 2 patients(6.9%).The length of ICU stay was 1.9?0.1 d and the length of hospital stay was 4~11 d(mean,7.5 d).Follow-up for 2.2?0.9 years showed no late death and myocardial infarction.Postoperative New York Heart Association(NYHA) Classification showed Class Ⅰ in 25 patients and Class Ⅱ in 4 patients.Repeated angiography was conducted in 4 patients,which found great saphenous vein graft occluded in 1 patient and stent re-stenosis in 2 patients.Conclusions The midterm results of hybrid techniques for coronary artery disease are satisfactory.Hybrid procedure is beneficial to high-risk patients.The long-term results need further investigation.

Objective: To investigate the effects of Shen-Mai injection(SM) on perfusion and oxygenation of intestinaltract during repeffusion in shocked rabbits. Methods:Twenty-one rabbits were divided into control group (Ⅰ,n = 6), shock-repeffusion group ( Ⅱ, n = 9) and SM group ( Ⅲ, n = 6). Intestinal intramucosal pH (pHi) of the sigrnoid colon and portalvein blood gas was observed before shock, at 1 hour after shock, 1 hour and 2 hours of reperfusion. Results: pHi and portal vein pH in group Ⅱ were significantly lower than those in group Ⅰ (P < 0.01), but portal vein increased obviously during reperfusion. There was a good linear positive correlation between pHi and portal vein pH. Portal vein in group Ⅱ was greater than that in group Ⅰ and had anegative correlation with pHi. pHi and portal vein pH of group Ⅲ increased signifi- cantly compared with those of goup Ⅱ ( P < 0.05), while of group Ⅲ returned to the level of group Ⅰ . MAP and CO of group m were higher than those of group Ⅱ after 1 hour or 2 hours reperfusion (P<0.05).CO of group m remained at a high level during reperfusion. But SVR of group Ⅲ was lower than that of group Ⅱ during reperfusion. Conclusion: SM im-proves perfusion and oxygenation of intestinal tract during reperfusion.

ObjectiveTo summarize the short-term effects o f Symmetry aortic co nnector in off-pump coronary artery bypass grafting (OPCAB) operation. MethodsTwo hundreds and four patients suffering from coronary artery d isease underwent OPCAB from September 2002 to June 2003. Among the 204 patients, saphenous vein grafts were used in 167 patients and Symmetry aortic connectors were adopted in 100 of them.ResultsOf 142 connectors used, 2 connectors fai led and manual r epairs were required in 3 cases because of anastomotic leakage, the success rate being 96 5% (137 of 142). The number of proximal anastomosis was (1 4?0 5) per case and the number of distal anastomosis (3 5?0 8) per case. The proximal a na stomotic blood flow was (46 5?22 3) ml/min. The fitting time for connectors w as (4 0?1 1) min, and anastomoses were all accomplished within 10 seconds. The op eration time was (3 2?0 4) hours. The operative death rate was 1% (1 of 100). R e-operation of thoracotomy was required in 1 case because of bleeding but not an astomotic bleeding. No myocardial infarction or stroke occurred in the peri-oper ative period. The postoperative drainage amount was (547?247) ml. The blood tra nsfusion rate was 36 0% (36 of 100). The postoperative hospital stay was (7 8 ?1 6) days.ConclusionsSymmetry aortic connector can be saf ely and effectively used in coronary artery bypass grafting operations, with satisfactory short-term clinical effects. The procedure may shorten operation time, avoid aortic clampi ng, and lower the incidence of stroke.

Objective To summarize the mid-term outcomes of minimally invasive direct coronary artery bypass (MIDCAB). Methods A series of 33 patients underwent MIDCAB from November 2000 to April 2003: 29 of them received MIDCAB only and 4 received the hybrid approach operation (combining MIDCAB of the left anterior descending artery with percutaneous coronary intervention of the remaining diseased coronary arteries). Out of the 33 cases, conventional MIDCAB was carried out in 25 cases, 4 underwent thoracoscopy-assisted operation and 4 received the surgery with the assistance of the AESOP robot system. Results No operation-related deaths or complications were seen in the study. The extubation time was (7.5?1.9) hours, the chest drainage volume was (274?197) ml, the blood transfusion rate 9.1% (3/33) and the postoperative hospital stay (6.9?1.7) days. Follow-up in all the 33 cases for (24.3?5.7) months revealed no long-term deaths and the recurrence rate of angina was 9.1% (3/33). Postoperative coronary angiography in 4 cases found 1 case of 50% stricture of anastomosis and 3 cases of anastomotic patency between the anterior descending artery and left internal mammary artery. Postoperative catheter revascularization was required in 2 cases (6%). Conclusions The mid-term outcomes of MIDCAB is satisfactory.

Objective To study and analyze the clinical effects of different oxytocin induced labor routes. Methods From March 2015 to September 2016, 100 pregnant women who needed induced labor or induced oxytocin were selected in our hospital. They were randomly divided into the control group and the study group, with 50 patients in each group. The control group with traditional infusion method, given intravenous indwelling needle puncture method in patients with the study group, select the vein elastic and straight, thick, pay attention to the reasonable sealing, adjust the dropping speed according to the patients with uterine contraction. The infusion speed, safety and accuracy of the patients in the study group and the control group were compared and analyzed. Results After the corresponding administration route, there were 0 patients with drop velocity errors in the study group, and 12 patients in the control group. In the control group, the rate of drop error was 24％, which was significantly higher than that of the study group (0％), with statistical difference (P<0.05). Among the patients in the study group, the number of blocked tubes was 1, the probability was 2％, the rate of subcutaneous infiltration was 4％, and the incidence of needle prolapse was 0％. In the control group, the rate of subcutaneous exudate was 10％, the probability of blockage was 8％, and the incidence of needle prolapse was 6％. The average time spent by the study group on regulation of drip speed was (8.09 ±2.10) s, significantly shorter than that of the control group (78.90 ± 9.20) s, with statistical difference (P<0.05). Conclusion Intravenous catheter infusion of oxytocin administered with traditional delivery mode, simple operation, can significantly reduce the drop speed error probability, the clinical effect is ideal, has the meaning of promotion.

Objective:To study if L-arginine cardioplegia can protect myocardium from ischemia/reperfusion injury. Method:Fourteen patients undergoing valve replacement were randomly divided into two groups:control group (crystal cardioplegia,C group),and test group(crystal cardioplegia+L-arginine,E group). Before aortic-clamping and after aortic unclamping,blood samples were taken to measure the concentrations of NO_2~-/NO_3~-, lactic acid (LA), malonylaldehyde (MDA), superoxide dismutase (SOD), xanthine oxidase (XOD). Immediately after aortic clamping and before aortic-unclamping, tissues were taken from the left atrial and examed with electron microscopy. Result: In C group NO_2~-/NO_3~- level decreased at aortic unclamping, 30 minutes later decreased significantly compared with that before aortic-clamping(P

0 05),increased markedly at R 3 in group C (P

ObjectiveTo evaluate biomechanical properties of transoralpharyngeal atlantoaxial reduction plate (TARP) prepared from magnesium alloy and titanium alloy for the atlantoaxial dislocation by using three-dimensional finite element analysis and to exam the feasibility of using magnesium alloy for preparation of TARP system so as to provide a theoretical basis for clinical surgery.MethodsA patient with typical atlantoaxial fracture dislocation was involved in the study,and received thin CT scan with clinically used titanium alloy TARP system for obtaining DICOM image data.Three-dimensional finite element analysis software was imported to simulate magnesium alloy and titanium alloy TARP systems for reduction and fixation.Then,stress changes of the atlas,axis,internal fixators and C2/3 zygapophysial joints were determined with three-dimensional finite element analysis and analyzed statistically.Results ( 1 ) The finite element model of atlantoaxial dislocation reduction and fixation had lifelike outline and good geometric similarity.There were 53 586 nodes and 180 784 units.(2) During the simulation of head in neutral position,the stress concentration region was C2/3 zygapophysial joints followed by the anterior arch,posterior arch and lateral mass of atlas respectively,and C2 vertebral arch again.( 3 )Magnesium alloy and titanium alloy TARP systems showed significant difference in stress distribution (P ＜0.05).Conclusions(1)The atlantoaxial model established according to its structure information on CT can be used for biomechanical experiments.(2) For the treatment of atlantoaxial dislocation using the existing titanium TARP system,maintaining the integrity of anterior and posterior arch of atlas and confirming the bone fusion in lateral mass can better keep the stability of the atlantoaxis.After atlantoaxial fusion,the increased stress of the zygapophysial joints of the adjacent segments accelerates structural degeneration,which should be closely followed up.( 3 ) Magnesium alloy TARP system for fixation and reduction shows the fall in peak value of the stress concentration region,and improvement of the uniformity of stress distribution as compared with titanium alloy TARP.

The paper is to report the establishment of three methods for determination of methyl salicylate-2-O-beta-D-galactopyranoside (1-4)-beta-D-glucopyranoside (MSG) by HPLC, UV or potentiometric titration. The results determined by the three methods turned out to be of no significant difference (P>0.05). The method was chosen according to MSG difference test demands.

Objective To investigate the imaging methods of multislice spiral CT (MSCT) of sternum and its diagnostic value in the sternum diseases.Methods 108 cases(100 cases in normal group and 8 cases in disorder group) underwent conventional chest volume scan and thin slice low contrast images reconstruction with 16-slice spiral CT.Then all the source images were processed using standard/curved multiplanar reconstruction(MPR), maximum intensity projection(MIP), surface shaded display (SSD) and volume rendering technique(VRT). All post-processed images were observed and analyzed by two radiologists. Results The sternums were clearly showed by the post-processed images.In displaying the structure of sternum, sagittal MPR was better than axial MPR (U=14.107, P=0.000) and coronal curve MPR was better than coronal MPR (U =11.882, P=0.000); in evaluating the shape of sternum , VRT was better than the imaging modes of MIP, SSD(UVRT:MIP =13.553, UVRT:SSD=12.102, P=0.000). Among 8 patients with sternum diseases, 5 cases of sternum fracture and 3 cases of sternum metastasis tumor were found. Conclusion Coronal curve MPR, sagittal MPR and VRT are the best imaging methods of MSCT to show sternum and they are markedly superior to conventional X-ray images and axial CT images in evaluating the sternum diseases.