Objective To evaluate the technique of coronary bypass grafting and its early result in 286 consecutive patients.Methods Two hundred and eighty-six patients from June 2002 to December 2005 underwent coronary artery bypass grafting.The average unmber of grafts was 3.3.Two hundred and eighty-three patients had left internal mammary artery bypassed to the left anterior descending branch.Other grafts were from saphenous veins.Results All patiens were clinical recovery.Respirator assisted within 0～28 hours(average 10).Conclusion Coronary artery bypass can be safely done with low mortality excellent surgical results even in patients with multi-vessel coronary artery disease.

Objective To investigate the protective effects of ulinastatin(UTI)on ischemia-reperfusion(I/R)injury(SMIRI)of skeletal muscle in rats.Method Twenty-four male SD rats randomly were divided into three groups in equal number:control group(Group C)rats underwent anesthetization without ischemia;the ischemia-reperfusion injury group(Group I/R)rats underwent ischemia and reperfusion,0.5 ml normal saline (N.S)was infused upon extermal jngular vein prior to reperfusion;ulinstatin group(Group U)underwent ischemia and reperfusion,and 0.5 ml UTI(5×104 U/kg)Was infused at the same time.The skeletal muscle injury model was induced by a rubber band tourniquet applied to the left root of the hind limb for 4 hours and reperfusion for 4 hours.At the end of study,the expression of TNF-α mRNA of skeletal muscle was determined by reverse transcription-polymerase chain reaction(RT-PCR);enzyme-linked immun-osorbent assay(ELISA)were performed for plasma level of TNF-α;the plasma concentrations of lactate dehydrogenase(LDH),creatine kinase (CK),malondialdehyde(MDA),myeloperoxidase(MPO)activity and MDA in skeletal muscle were measured by colorimetry respectively.The oedema degree was quantified by calculating the wet/dry weight ratio of skeletal muscle.Structural changes of skeletal muscle were also observed histologically and ultrastructurally.The statistical difference was analyzed with One-way ANOVA by SPSS version 10.0 Software for windows.Results The level of plasma TNF-α,TNF-α mRNA expression in skeletal muscle in group I/R were significantly higher than those in Group C(P＜0.01),while those in Group U were significantly lower than those in Group I/R(P＜O.01).The plasma concentrations of LDH,CK,MDA and the MPO activity,W/D of skeletal muscle varied in those groups were likewise in comparinson between groups(P＜0.05).The histologic changes of skeletal muscle tissue under light and electronic microscopy were slingter in Group U than in group I/R.Conclusions UTI can inhibit the production of inflammatory factors and MDA,and suppress the MPO activity,showing protective effects against ischemia-reperfusion injury of skeletal muscle of rats.

Objective Hotelling T2 Test was used to analyze the effect of sibutramine and to provide some information for new drug's exploration. Method Fifty-five patients with body mass index (BMI) over 25kg/m2 were selected according to generally accepted including and excluding criteria. The subjects were divided into 2 groups randomly. Control group was given placebo, and the experimental group were given sibutramine. Biological and biochemical indexes were examined pre-,during and post- clinical trial. Hotelling T2 test was used to compare the index mean vector of different phases. Results There were significant statistical differences between the two groups. (P

Objective To investigate the age related bone mineral density and the prevalence of osteoporosis at different skeletal sites in old women(age super-40 years) in Changsha countryside. Methods 627 healthy women from Changsha countryside (40 to 85 years)were involved. BMD measurements were taken at various sites,included anteroposterior and lateral lumbar spine, hip and forearm by Hologic QDR4500A dual energy X-ray absorptiometry (DEXA). Data were analyzed in-groups divided by an interval of every 5 years of age.Results ⑴Compared with 40 years～ old women, 75～85 years old women's total bone loss rates were highest at the word's triangle (56 62%) and lowest at the 1/3 site of the distal forearm (29 82～31 43%). ⑵The rank of osteoporosis detection rate from high to low after age 40 was lateral lumbar spine (38 72%), forearm, ward's triangle (27 52%) and anteroposterior lumbar spine ; femur neck and major trochanter (8 28% and 8 85%).⑶the prevalence of osteoporosis at least at one site of these women were(1 127?1 3)% in the age of 40～, (2 3?3 99)% in the age of 45～, (10 16?9 2)% in the age of 50～, (28 85?15 63)% in the age of 55～,(46 55?21 35)% in the age of 60～, (63 31?20 62)% in the age of 65～, (76 67?17 5)% in the age of 70～, (77 07?17 67)% in the age of 75～85. Before 60 years old the prevalence of osteoporosis stands out at lumbar spine (P

Objective To evaluate the value of thoracotomy through small right subaxillary oblique incision for pediatric ventricular septal defect(VSD). Methods From November 2001 to December 2008,1539 children with VSD underwent thoracotomy through small right subaxillary oblique incision in our hospital.At the fourth intercostal space between the anterior and middle axillary lines,a straight or oblique incision was made,then along the inferior edge of the fourth rib the chest was opened,and the right edge of the pericardium was fixed at the thoracic retractor.Afterwards,off-pump circulation was established and minimally invasive cardiac surgery was carried out.Results The procedure was completed successfully in all the 1539 patients.The cross-clamp time was(22.8?11.4) min(11 to 48 min),and CPB time was(33.0?14.9) min(27 to 64 min).Two patients(0.13%,2/1539) died in 24 hours after the operation.One of them died of severe allergic reaction to protamine.And the other died of severe low cardiac output in 4 hours after the surgery,because of an injury to the left coronary artery.In this series,the postoperative complications included incisional infection in 3 cases,atelectasis in 9,perfusion lung in 5,low cardiac output in 5,infectious endocarditis in 3 and acute renal failure in 4.These 29 cases were discharged after the complications being cured.Follow-up was available in 1446 cases for(47.0?11.2) months(range,6~91 months).During the period,small residual shunts in the VSD were detected in 5 cases,and other cases showed no abnormalities.Conclusions Thoracotomy through small right subaxillary oblique incision is minimally invasive,safe and effective for pediatric VSD.

Objective:To investigate the effect of local application of the water soluble protein fraction,containing specific egg yolk antibody,on the recolonization of Streptococcus mutans.Methods:Whole cells of inactivated streptococcus mutans were used as antigen to immunize bens,then water soluble protein fraction(WSF) was extracted from the eggs. Mouth wash containing 0.1 mg/ml of WSF was prepared and administered to 8 volunteers.The mouth wash was used once every two days for 2 weeks.Vehicle solution was used in other 6 volunteers as the control.S.mutans in saliva was monitored for 100 days.Results:Before using the mouth washes,S.mutans level in saliva of the volunteers was 36.4%.S.mutans was removed by hibitane,it kept less than 3% in 100 days in the tested individuals,while 23%～37% in the controls.Conclusion:The WSF containing specific egg yolk antibody can effectively prevent the recolonization of streptococcus mutans.

Objective To investigate the clinical efficacy of mesalazine combined with bifico in the treatment of ulcerative co -litis (UC) and its effect on toll-like receptor 4 (TLR4) and myeloid differentiation factor 88 (MyD88).Methods A total of 86 cases of UC was randomly divided into the observation and control groups with 43 cases in each group .The observation group was given me-salazine combined bifico treatment , and the control group was given mesalazine , and eight weeks as a course of treatment .The clinical efficacy was observed .Serum TLR4 and MyD88 were tested.Adverse reaction in treatment was recorded .Results The total effective rate (95.35%) in observation group was significantly higher than that (81.40%) in control group( P <0.05).The serum TLR4 and MyD88 after treatment of two groups were significantly lower than that before treatment , respectively ( P <0.05 or P <0.01 ) , and the decline in TLR4 of observation group was superior to that of control group ( P <0.05 ) .The difference of adverse reaction rate in two groups was not significant ( P >0.05 ) .Conclusions Mesalazine combined with bifico in the treatment of UC is safe and effective . The effect may be related to regulation of peripheral blood TLR 4 and MyD88 content .

Objective To explore the radical surgery for tetralogy of Fallot combined with right pulmonary artery stenosis.Methods Thirteen cases with tetralogy of Fallot combined with right pulmonary artery stenosis accepted radical surgery,among them 7 cases who-had a long right pulmonary artery stenosis accepted aortic transaction for radical surgery of tetralogy of Fallot;5 cases who had the entrance stenosis of the right pulmonary artery accepted right pulmonary artery patch expansion for radical surgery of tetralogy of Fallot;One case who had the distortion and stenosis after pulmonary shunt accepted the radical surgery for tetralogy of Fallot after seperation and expansion.Results There were no operation-related deaths,post-operative low cardic output and perfusion lung occurred for all the cases.Ten cases had grade 1 cardiac function and 3 cases had grade 2,respectively.Conclusion Right pulmonary artery stenosis increased the risks during the radical surgery for tetralogy of Fallot,but it is still the primary operation choice.

Objective To evaluate the value of carotid artery bruit in predicting carotid stenosis in patients with cerebral arterial thrombosis. Methods Two hundred cerebral arterial thrombosis patients were divided into bruit group and no bruit group according to carotid artery auscultation,with 100 cases in each group. The patients with cardiac murmur, vein sound and thyroid noise were excluded from bruit group. The examination of carotid artery auscultation (transcranial Doppler sonography ) was managed in all the patients,and digital subtraction angiography (DSA) about aortic arch and the whole brain were perfomed. The carotid stenosis rate, site, degree were compared and the relationship between carotid bruit grade and carotid stenosis degree were evaluated. Results The carotid stenosis rate in bruit group [67% (67/100)] was higher than that in no bruit group [29%(29/100)](P＜ 0.01 ). There was significant difference in the carotid stenosis site and degree between two groups (P ＜0.05). Carotid bruit were significantly associated with stenosis near carotid bifurcation or serious stenosis (P ＜ 0.05). The carotid bruit grade was positively related with the carotid stenosis degree (P ＜ 0.05 ). Conclusions Carotid bruit is associated with site and degree of carotid stenosis. Carotid bruit is valuable in screening for carotid stenosis in patients with cerebral arterial thrombosis.

Objective To investigate the blood-saving effect of tranexamic acid in patients undergoing Stanford type A aortic dissection surgery.Methods Fifty-six patients of both sexes with acute Stanford type A aortic dissection, aged 34-58 yr, weighing 62-84 kg, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ , with their left ventricular ejection fraction ＞ 40％, undergoing emergency surgery, were randomly divided into 2 groups: control group (group C, n=26) and tranexamic acid group (group TA, n=30).Tranexamic acid was infused as a bolus of 10 mg/kg over 30 min before skin incision followed by an infusion of 10 mg · kg-1 · h-1 throughout the surgery in group TA.The equal volume of normal saline was given instead in group C.The total volume of drainage at 24 h after operation, the postoperative requirement of allogeneic red blood cells, fresh frozen plasma and platelets, and re-thoracotomy for bleeding were recorded.The postoperative mechanical ventilation time, duration of intensive care unit stay, and complications after operation were also recorded.Results Compared with group C, the total volume of drainage at 24 h after operation, and the requirement of allogeneic red blood cells, fresh frozen plasma and platelets were significantly reduced, the incidence of rethoracotomy for bleeding was decreased, the postoperative mechanical ventilation time, and duration of intensive care unit stay were shortened, and the incidence of postoperative acute lung injury and transient neurological dysfunction were decreased in group TA.Conclusion Tranexamic acid has blood-saving effect and can reduce postoperative bleeding and allogeneic blood transfusion in patients undergoing Stanford type A aortic dissection surgery.