Objective To review the outcome of coronary artery bypass graft (CABG) using left internal thoracic artery grafts in the patients aged over 70 years old.Methods Two hundred and eighty-eight patients aged over 70 years old from January 2009 to January 2014 who underwent CABG were selected.All of the patients were divided into two groups on base of the graft:control group:only saphenous vein graft was used in 138 cases; observation group:the left internal thoracic artery to the left anterior descending artery was used in 150 cases,which also included total arterial grafting,facilitated by the use of the radial artery,right gastroepiploic artery was operated in 7 cases,beside these artery grafts,saphenous vein graft was used to anastomosis with other vessels.Results Operative mortality was 2.9％ (4/138) in control group and 2.0％ (3/150) in observation group,and there was no significance (P ＞ 0.05).The volume of blood drainage was larger in observation group [(796.2 ± 382.4) ml] than that in control group [(512.8 ± 387.5) ml],and there was significant difference (P ＜ 0.05).At the same time,there was no significant difference in the incidence rate of second thoractomy,malignant arrhythmia,stroke,poor wound healing,and usage of intraaortic balloon counterpulsation between two groups (P ＞ 0.05).Conclusion It does not increase the mortality and incidence of serious complications using the left internal thoracic artery to the left anterior descending artery in the patients aged over 70 years old during CABG.

There are some major changes win the revised 2016 WHO Classification of Lymphoid Neoplasms.Based on the clinicopathological changes and genetic/molecular findings in the past years,the new classification clarified the diagnosis and clinical management of some very early stages of lymphoproliferative disorders,refined the diagnostic criteria for some lymphoid neoplasms,and further emphasized the significance of genetic/molecular studies in the diagnosis and clinical treatment of lymphomas.A small number of new provisional entities were added to the 2016 edition.

Oxidative stress and inflammation are two main factors in the progress of diabetic nephropathy(DN) and its complications. NF‐E2 p45‐related factor (Nrf2) is a crucial transcriptional factor which manipulates downstream genes that encode some antioxidant enzymes and phase Ⅱ detoxifying enzymes ,to maintain the redox homeostasis and cellular detoxification response. Therefore ,more and more researchers are focusing on the role of Nrf2 in DN. In this review ,the detailed role of Nrf2 in DN will be discussed. Hopefully ,our work can epitomize recent research progress and provide novel clues for diabetic nephropathy prevention and treatment.

Objective To investigate the predictive value of epicardial adipose tissue(EAT) thickness for the recurrence of atrial fibrillation (RAF) after concomitant valve replacement and bipolar radiofrequency ablation.Methods From January 2012 to May 2014,156 patients with permanent atrial fibrillation and organic valvular diseases underwent concomitant valve replacement and successful bipolar radiofrequency ablation in the First People's Hospital of Shangqiu.After 1 year of follow-up,the recurrence of AF was analyzed and the correlation factors were analyzed statistically.Results All patients completed a regular follow-up.During a 12-month follow-up period,RAF was observed in 39 patients (25.0％).Echocardiography-derived regional EAT thickness was significantly greater in RAF patients than that in non-RAF patients((6.9±0.6) mm vs.(5.5±0.7) mm,t=4.649,P＜0.05).The EAT thickness strongly correlated with patients age,body mass index,Ratio of left atrial diameter,mitral diastolic blood flow velocity and early diastolic velocity of mitral annulus,low density lipoprotein-cholesterol and thyroglobulin (r =0.62,0.57,0.68,0.59,0.73,0.76;P ＜ 0.05).Cox multivariable analysis showed that,duration of AF history (95％CI:1.01-1.15,P =0.040),left atrial diameter (95％CI:1.07-1.24,P =0.021) and EAT thickness (95％CI:1.05-1.79,P =0.009) were independent predictors of RAF.Conclusion Echocardiography-derived regional EAT thickness combined with left atrial diameter may serve as effective parameters in identifying patients at the highest risk for RAF.

Tumor vaccine is one of the most promising therapeutic strategies in tumor immunotherapy. It promotes the antigen presentation process by delivering tumor antigen and then activates the anti-tumor immune response. As a new class of vaccines, messenger RNA (mRNA) vaccines can activate the immune system to achieve the purpose of immunotherapy by delivering the mRNA sequence of a specific antigen into the body and expressing the corresponding antigen protein. Compared with traditional vaccines, mRNA vaccines have the advantages of a short production cycle, high effectiveness, and strong immunogenicity. In recent years, the application of mRNA vaccines in tumor immunotherapy has attracted widespread attention, but the instability and low delivery efficiency of mRNA limit its application. Nano delivery system can effectively solve the problem of mRNA vaccine delivery, greatly promote the research process and clinical application of mRNA tumor vaccines, and has become a hot spot in the research of mRNA vaccines. In this review, we introduced the mRNA tumor vaccines, focusing on the application of nano delivery system in mRNA tumor vaccines, in order to provide new ideas and new methods for the efficient delivery of mRNA tumor vaccines and tumor immunotherapy.

Objective:To compare the DNA character with in cholesteatoma tissues with that in normal skin.Method:DNA content within 25 cholesteatoma tissues and 10 normal postauricular skin was measured with flow cytometry.Result:The content of cholesteatoma tissues and postauricular skin specimens are a normal euploid.The cell number during S phase of cholesteatoma(10.9±2.32)% was higher than that in normal skin(7.31±2.82)%.Conclusion:Although the cholesteatoma has a very high proliferating character,the result suggest it isn′t a malignant tumor.

Objective To evaluate the clinical efficacy of combined use of Pathfile and Mtwo in the preparation of curved root canals.Methods This study enrolled a total of 90 teeth(313 root canals)that need root canal therapy because of pulpitis or apical periodontitis from December 2013 to February 2014.All root canals were randomly divided into three groups.In group A,both Pathfile and Mtwo NiTi files were used in root canal preparation.In group B,Pathfile and ProTaper were used.ProTaper was employed alone in root canal preparation in group C.The high temperature thermaplasticized inj ectable ver-tical condensation technique was applied in all the three groups.The time of root canal preparation,the number of separated de-vices,root canal transportation and the quality of root canal filling were obtained and compared among the 3 groups.Results In group A,the time of root canal preparation was shortest,(6.01±1.12)min ;there were no instrument separation and ledge for-mation,and the filling rate was highest in group A.The differences were significantly noted in these indexes between group A and groups B,C.Conclusion Combined use of Pathfile and Mtwo for preparation of curved root canals is fast and safe,and the root canal filling is satisfactory.This method is suitable for clinical application.

The expression of proliferating cell nuclear antigen (PCNA) and B-cell lymphoma/leukemia-2 gene (Bcl-2) was detected in 25 cases of cholesteatoma tissues and 10 cases of normal skin by using immunohistochemical technique. The results showed that the PCNA index of cholesteatoma tissues was higher than that of normal skin, but Bcl-2 was not expressed in cholesteatoma tissues and normal skin. The PCNA index was correlated with the aggressiveness of cholesteatoma. It was suggested that PCNA could be considered to be a prognostic marker and an indicator of aggressive behavior in cholesteatoma. Although the cholesteatoma had a very high proliferating character, it wasn't a malignant tumor.

The scientificalness of traditional Chinese medicine (TCM) is often doubted and criticized for the record in Huangdi Neijing that the liver is located in the left of the human body. The most popular explanation of this criticism is that the conception of zang-fu viscera in TCM is quite different from which defined in Western medicine. It means that the zang-fu viscera in TCM are not exactly the corresponding anatomical organs in modern human anatomy but reflect the functions of some systems in human body. According to the classical theories of TCM in Huangdi Neijing, we consider that the record of liver located in the left of the human body is based on the Ba Gua (Eight Diagrams) of traditional Chinese philosophy, not the human anatomy. In brief, the conception of zang-fu viscera is initially a gross anatomical conception, and in a sense the anatomic sites and functions of which are mostly similar to those described in Western medicine.

The ancient theory and technology which are related to preventive treatment of disease by dietetic regulation and coordinating meridian according to 25 tones have been developed in the early 21st century. It is proved in sonocytology by nanotechnology that cells are able to produce noise, and the noise will change at first when the cells have any disorders. This theory is in accordance with the one in Huangdi Neijing. The nanotechnology can be introduced into the basic research of traditional Chinese medicine and may contribute to the modernization of traditional Chinese medicine.