Objective To evaluate the prognosis and influencing factors of unprotected left main coronary artery lesion intervention with drug-eluting stents.Methods Forty-five patients with unprotected left main coronary artery disease were treated with percutaneous coronary intervention (PCI).According to whether the lesions involving the distal left main bifurcation,the patients were divided into two 2 groups:nonbifurcation lesion group (26 cases) with opening or body disease,bifurcation lesion group (19 cases) with involving the distal left main or anterior descending artery,circumflex openings.Fifteen patients were guided by intravascular ultrasound (IVUS) during PCI,and 13 patients were reviewed by coronary angiography at (9.5 ±6.3) months after PCI.Results All the 45 patients were successful.There were 42 patients successfully finished the follow-up study for the average of 8-48 (19.9 ± 10.2) months,non-bifurcation lesion group was 24 cases,bifurcation lesion group was 18 cases.The incidence of recurrent angina pectoris during the follow-up period in bifurcation lesion group was significantly higher than that in non-bifurcation lesion group [6/18 vs.12.5％ (3/24)],there was statistical difference (P ＜ 0.05),but there was no statistical difference in the incidence of major adverse cardiac events (MACE) between 2 groups [3/18 vs.12.5％ (3/24),P ＞ 0.05].Single-variable analysis results showed that MACE in IVUS guided during PCI was less than that in non-IVUS guided during PCI [1/15 vs.18.5％(5/27)],there was statistical difference (P ＜0.05).In 13 patients who reviewed by coronary angiography,4 patients were found in-stents restenosis,all in bifurcation lesion group,the rate of restenosis in double stents was 3/6,in simple stents was 1/4.Conclusions PCI with drug-eluting stents is safe and feasible for the treatment of selective left main coronary artery lesion,it could bring the better short and long-term outcomes.IVUS guided PCI could significantly reduce MACE.

This paper elaborates on the significance of'birth,growth,transformation,harvest,store'from the theory of TCM fi ve elements.Then it mainly discusses the harmonious development of five aspects of TCM science in research,education,market,hospitals and infrastructure from the view of respective functions of'birth,growth,transformation,harvest,store'and the TCM idea that conforming to certain climate can help people keep healthy.Finally,the paper indicates that it is necessary for the government to guide and adjust the development of TCM in different stage from a dynamic view.

A 74-year-old man presented with yellowish red nodules and plaques on the trunk for more than one year.Physical examination showed more than 20 scattered,irregularly shaped,well-demarcated,yellowish red nodules and plaques measuring 0.5-15 cm in diameter on the trunk.The plaques on the right lower abdomen showed central ulceration and atrophy with scar formation.Plasma protein electrophoresis revealed that the levels of immunoglobulin G (IgG) and kappa light chain were 18.3 g/L and 20.70 g/L respectively.Histopathologically,large necrobiotic areas and granuloma were observed alternately in the dermis and subcutis.There were numerous Touton giant cells,foreign body giant cells and foamy histiocytes in the granuloma,and many cholesterol clefts were found in the center of necrobiotic areas with the formation of lymphoid follicles in some regions.Both eyes of the patient were involved to different degrees.He was diagnosed as necrobiotic xanthogranuloma with IgG kappa paraproteinemia and eve involvement.

Objective To evaluate the effectiveness of urgent surgical correction for infra-cardiac total anomalous pulmonary venous drainage (TAPVD) in infants and children. Methods From July 2000 to April 2009, seventeen patients with infra-cardiac type of total anomalous pulmonary venous connection received surgical correction in our department. The age of patients ranged from 15 days to 3.7 months at admission, 9 patients ( 52.9 % ) were younger than 1 month of age. The mean body weight was (4.10 ±0.95) kg and was less than 5 kg in 15 patients (88.2%). Deep hypothermic circulatory arrest (DHCA) without cerebral perfusion was used in 13 patients (76%), and continuous hypothermic low-flow perfusion was used in4 (24%). Incisions on the left atrium and pulmonary veins were sutured without tension, and the width of the anastomosis was 2.5 to 4.0 cm. Results Urgent operations were performed in all patients and no early death occurred during surgery.Mean bypass time was 121.9 minutes ( ranging from 70 to 277 minutes) and mean aortic cross-clamp time was 44 minutes ( ranging from 30 to 74 minutes). 6 neonates had delayed wound closure after surgery and 4 had obvious pulmonary edema. Inhalation of nitric oxide was given to 5 cases for the management of significant postoperative pulmonary hypertension, while peritoneal dialysis was performed in 2 cases with temporary renal failure. Transient atrioventricular block of grade 3 occurred in 2patients and acute renal failure occurred in 2 cases. All patients were uneventfully discharged. The mean ventilation time was 45 h (ranging from 12 to 430 h). Mean duration in ICUs and hospitals were 15 days ( ranging from 4 to 40 days) and 22. 5days ( ranging from 10 to 42 days), respectively. During the period of follow up, one patient presented with pulmonary venous obstruction and recurrent pulmonary infection with increased flow speed at the site of anastomosis, pulmonary hypertension and tricuspid regurgitation on echocardiogram. No improvement was observed in the patient spite of medical treatment and he was lost during follow up one year after operation. 16 patients received postoperative follow up for 1 month to 9 years, mean (51.8 ± 35.0) months. Echocardiography, chest radiography, and ECG were performed during this period. As a result, most children had good cardiac function, with sinus rhythm on ECG and apparently reduced pulmonary congestion on radiography.No obstructive pulmonary venous return was observed on echocardiography. Most patients had good cardiac functions. Conclusion Corrective operation for infra-cardiac TAPVC on urgent basis may provide favorite outcomes. The prognosis is associated with the size of anastomosis between the pulmonary vein and left atrium, as large anastomosis may prevent the obstruction of pulmonary venous retum.

Objective To explore the characteristics of ischemia-reperfusion induced infant lung damage and the potential mechanisms of the injuried.Methods Both infant (15-21 days old) and adult (5-6 months old) rabbits were subjected to either ischemia-reperfusion or sham operation.Ischemia-reperfusion was induced by clamping the right pulmonary hilum for 1 hour and then removal of the clamp for 4 hours under anesthesia.The lung tissue were sampled for histological examination by light and electron microcopies and for biological evaluation of mitochondrial alterations.Production and expression of free radical species-hydroxyl radical (ROS-HR),malondialdehyde (MDA),superoxide dismutase (SOD),glutathione peroxidase (GSH-PX),myeloid differentiation factor-88 (MyD-88),and nuclear factor-κB (NF-κB) in the lung tissue were also examined.In addition,circulating levels of interleukin-β and tumor necrosis factor-α were measured during the ischemia-reperfusion process.Results In comparison to adult lungs,the infant lungs had more increased neutrophil infiltration,edema,swelled alveolar epithelial and endothelial cells,and severer mitochondrial impairment reflected by damage of the inner membrane as well as decrease in the membrane potential after ischemia-reperfusion.The lungs in infant animals subjected to sham operation displayed higher levels of ROS-HR and MDA and lower levels of SOD and GSH-PX than those in adult controls.The lungs in infants with ischemia-reperfusion were found to further produce more ROS-HR,and MDA,and less SOD and GSH-PX than the ischemia-reperfused adult lungs.Moreover,the circulating levels of interleukin-1β and tumor necrosis factor-α were elevated during the period of ischemia-reperfusion,particularly in the infant animals,which appeared to be associated with the expression of MyD-88 and NF-κB in the lungs.Conclusion Lung ischemia-reperfusion causes more severe lung damage in infants than in adults,probably due to combination of low antioxidant capacity and overproduction of ROS in infants.

Objective To establish a novel experimental model of New Zealand rabbit to assess the biocompatibility of 0.1 mm polytetrafluoroethylene (PTFE),a novel material of pulmonary valve.Methods Forty-two adult New Zealand rabbits about 3 kg were selected to give 35 mg/kg ketamine and 0.25 mg/kg dexmedetomidine intramuscularly for the anesthesia.The chest was open to expose the upper segment.The surface of right ventricular outflow tract (RVOT) was exposed after the pericardium was opened partially.The valve material (0.1 mm PTFE) was inserted into the right ventricle via the central mini-incision.Then the skin was closed and the rabbits were recoved with the oxygen inhalation.Results Forty-two adult New Zealand rabbits accepted the operation.Six rabbits died during the early period due to the inappropriate anesthesia drug (n =2),pneumothorax (n =1) and thrombosis (n =3),which occurred the 5th,7th and 8th postoperative day.The anticoagulation treatment was adjusted to solve the thrombosis problem.Thirty-six rabbits survived for several months with weight increase until the experiment was finished.Conclusions The experimental model of New Zealand rabbit is appropriate for the biocompatible assessment of 0.1 mm PTFE.The advantage is to avoid intubation and cardiopulmonary bypass (CPB) and to decrease the pneumothorax.

Objective To evaluate it' s prognosis according to the follow-up statistics of coronary reimplantation of anomalous left coronary artery originating from the pulmonary artery (ALCAPA).Methods Analyze the preoperative,peri-operative and postoperative data of 20 ALCAPA patients having undergone coronary artery reimplantation.Results After coronary reimplantation,patient' s cardiothoracic ratio was obviously decreased,the degree of myocardial ischemia was improved according to electrocardiogram,the left ventricular ejection fraction and fractional shortening showed a trend of rise,mostof the patients recover in 6 months to 1 year after coronary artery reimplantation.Left ventricular end-diastolic volume index over time gradually returned to normal,mitral regurgitation gradually.improved.Conclusion ALCAPA is rare and fatal,therefore it should be diagnosed and treated as early as possible.It is also significant to avoid missed diagnosis and misdiagnosis.After coronary reimplantation,cardiac function can be gradually restored with low mortality and good prognosis result.The left ventricularejection fraction of most patients recovers to the normal standard in six months to one year' s time.

The field of two-dimensional (2D) nanomaterial-based cancer immunotherapy combines research from multiple subdisciplines of material science, nano-chemistry, in particular nano-biological interactions, immunology, and medicinal chemistry. Most importantly, the "biological identity" of nanomaterials governed by bio-molecular corona in terms of bimolecular types, relative abundance, and conformation at the nanomaterial surface is now believed to influence blood circulation time, bio-distribution, immune response, cellular uptake, and intracellular trafficking. A better understanding of nano-bio interactions can improve utilization of 2D nano-architectures for cancer immunotherapy and immunotheranostics, allowing them to be adapted or modified to treat other immune dysregulation syndromes including autoimmune diseases or inflammation, infection, tissue regeneration, and transplantation. The manuscript reviews the biological interactions and immunotherapeutic applications of 2D nanomaterials, including understanding their interactions with biological molecules of the immune system, summarizes and prospects the applications of 2D nanomaterials in cancer immunotherapy.