Objective To investigate the clinical significance of small incision thoracotomy cardiac surgery in the management of heart diseases.Methods A retrospective analysis was made on clinical data of 115 cases of heart diseases treated with small incision thoracotomy surgery from September 2001 to October 2004 in this hospital.Results There were 108 cases of operation through a right small thoracic incision, 5 cases of robot-assisted operations,and 2 cases of occlusion of atrial septal defect(ASD) through a right small thoracic incision.The extracorporeal circulation time was 21~155 min(mean,145?26 min) and the aorta occlusion time was 8~108 min(mean,28?19 min).No operation-related death was seen.Postoperatively,a re-operation of open surgery was required for stopping bleeding in 1 case(0.9%,1/115),pulmonary atelectasis occurred in 3 cases(2.6%,3/115),and cerebral infarction happened in 2 cases(1.7%,2/115).Follow-up checkups in 82 cases for 6~24 months(mean,18 months) revealed no thoracic deformity.Conclusions With advantages of minimal injury,less bleeding,and quick closure of thoracic incision,right small incision thoracotomy is a good approach for the correction of cardiac deformities.

Objective To investigate the clinical features of primary angiitis of the central nervous system (PACNS). Methods The clinical data of 27 patients with PACNS were analyzed. Results PACNS commonly occured in young and middli-aged adult and with acute or subacute onset. The clinical manifestations were mainly including headache,decrudescence of cortical functions,focal neurological deficits and seizures. The hypointensity signals on T1WI and T2WI were showed and could be enhanced at lesions by skull MRI. The pia vessels inflammatory lesions were revealed in brain by pathological examination. The treated with glucocorticoid and combined therapy such as anti platelet aggregation,scavenging free radicals,reducing intracranial pressure,improving microcirculation and promoting neuronic metabolism,the condition get better.Conclusions The clinical manifestation of PACNS is various. The diagnosis can be make by combining the data of clinical features,imaging and brain biopsy.The treatment with glucocorticoid can obtain better efficacy.

Forty-seven patients with congenital heart disease and pulmonary hypertension were treated surgically. Among them, 31 were male and 16 female. The age ranged from 2 to 47(13. 7? 11. 2) years. Gongenital heart abnormalities included ventricular septal defect (VSD) in 20, huge atrial septal defect (ASD) in 1, VSD+ASI) in 12, VSD with patent ductus arteriosus (PDA) in 6, endocardial cushion in 2, VSD with aortopulmonary septal defect (APSD) in 1, double outlet right ventricle with PDA in 1 and total anomalous pulmonary venous connection in 1. Right heart catheterization was performed in 15 cases. The mean pulmonary artery pressure was (73 ? 24)mmHg, total pulmonary resistance was (78. 0 ?61. 2)kPa/(L/s). There were 7 cases examined in operation. Their mean pulmonary artery pressure was (55?13)mmHg. The others were examined by echocardiography. The mean pulmonary artery pressure was (49?15)mmHg. All patients were treated pre-op-eratively with oxygen inhalation therapy, hyperbaric oxygenation, prostaglandin E1 , respectively according to the degree of pulmonary hypertension. During cardiopulmonary bypass, pulmonary artery perfusion was performed with protective solution containing aprotinin for lung protection. Vasoactive drugs were routinely administrated postoperatively. There were 2 operative deaths with hospital mortality rate of 4. 3%. The cause of deaths was severe low cardiac output syndrome. The postoperative morbidity rate was 4. 3%. Our conclusion is proper peri-operative management could reduce post-operative mortality and morbidity for congenital heart disease with pulmonary hypertension.

Objective To investigate the serum asymmetric dimethylarginine (ADMA)expression in patients with acute cerebral infarction. Methods A total of 100 patients with acute cerebral infarction admitted to the Department of Neurology,the First Affiliated Hospital of Xi′an Medical College from March 2013 to August 2015 were enrolled retrospectively. According to the National Institutes of Health Stroke Scale (NIHSS)scores,they were divided into three groups:mild infarction (n =21;<4),moderate infarction (n =49;4 -15),and severe cerebral infarction (n = 30;> 15);100 healthy subjects without cerebrovascular disease in the same period were used as a control group. Enzyme linked immunosorbent assay was used to detect the plasma ADMA concentration,and the levels of plasma ADMA among the groups were compared. Results The concentrations of plasma ADMA of the mild,moderate,severe cerebral infarction,and the control groups were 0. 80 ± 0. 16,1. 14 ± 0. 28,1. 33 ± 0. 33,and 0. 52 ± 0. 16 μmol/ L,respectively. There were significant differences among the groups (F = 2. 32,P < 0. 05). Multivariate logistic regression analysis suggested that ADMA was an independent risk factor for cerebral infarction (OR,1. 140,95% CI 1. 078 -1. 212,P = 0. 045). Conclusions The expression levels of plasma ADMA increased gradually in patients with mild,moderate,and severe cerebral infarction. The higher the ADMA levels,the severe the neurological deficit would be. ADMA might be an independent risk factor for cerebral infarction.

ObjectiveTo investigate the gene expression profiling of articular chondrocyte and the function and pathway of the differentially expressed genes in patients with osteoarthritis (OA) by using gene microarray technique.MethodsThree patients with OA,three patients with rheumatoid arthritis(RA) and three traumatic controls without arthritis were selected and were divided into OA versus RA and OA versus the traumatic control groups,and their articular cartilage cells were cultivated.The gene expression profiling was performed by human genome oligonucleotide microarray technique.The differences of gene expression of the articular chondrocyte in OA versus RA group and OA versus the traumatic control group were compared respectively by two class unpaired test using significant analysis of microarray software.The function and pathway of these differentially expressed genes were analyzed by using the database of Molecule Annotation System.ResultsThe number of differentially expressed genes was 145 when OA compared with the traumatic control,in which 70 were up-regulated and 75 were down-regulated; and the number was 281 when OA were compared with RA,in which 94 were up-regnlated and 187 were down-regulated.The Gene Onto-logy (GO) functions of the differentially expressed genes of OA in each group were related to pathological and immune courses including cellular process,physiological process,cell division,biological regulation and cell signal transduction.The statistically significant pathways of these genes in each group included apoptosis pathway,cell cycle pathway,P53 signaling pathway,Fas signaling pathway,NO pathway,apeptotic cascade pathway,focal adhesion pathway, ECM-receptor interaction pathway, tight junction pathway, adhesive bonding pathway,actin cytoskeleton regulation pathway,bone remodeling pathway,chondroitin sulfate biosynthesis pathway,Jak-STAT signaling pathway,Wnt signaling pathway,Toll recepor signaling pathway,cell adhesion molecules pathway,T cell receptor signaling pathway,and s o on (P＜0.05).They displayed not only marked dif-ferences in GO function and gene pathway of differentially expressed genes between OA versus RA group and OA versus the traumatic control group,but also displayed the significant overlapping of the differentially expressed genes and pathways between the two groups.ConclusionThe differentially expressed genes and pathways of articular chondrocytes involve apoptosis,extracellular matrix and cytokines in OA,which contri-bute to further study of early warning genes of OA.

Objective:To obtain oligonucleotide aptamers which can specifically bind to Bacillus anthracis spores by in vitro selection protocol-SELEX (system evolution of ligands by exponential enrichment).Methods:An in vitro synthesized 78 mer random DNA library (≤1014-15types of different DNAs ) was subjected to 15 rounds of selection using SELEX method against spores of B.anthracis vaccine strain A.16R. Binding of the aptamers to spores was visualized by biotin-streptavidin-horseradish peroxidase system.Results:PCR amplification band pattern of the first round selection was different from that of the ninth round. The binding assay demonstrated that D absorbance at 450 nm of the fifteenth round pool increased 9 times as compared with that of the first round , and the D absorbance increased with the increment of aptamers′ quantity binding to spores. Conclusions: A set of aptamers with considerable binding affinity to B.anthracis spores were successfully selected from the initial random DNA pool.

Objective To share the experience of heart thransplantation. Methods 3 recipients with terminal myocardiosis were reviewed. The transplantation was performed with inferior and superior vena anastomofic technique. During perioperative period, we selected and maintained the recipients, protected donor-isolated heart, supported circulation,decreased immune reaction and controlled infections. Results All the 3 patients survived. Heart function improved from NYHA class 1V before heart transplant to NYHA class Ⅰ, Ⅱ. The follow-up time was 19 months ,28 months and 49 months respectively. Rejection occurred in two cases due to non-compliance to medication. Conclusions Suitable recipient, proper donor heart procurement and preservation, suitable maintenance of circulation, proper managements of anti-immunitive reaction, prevention of infections are critical for successfal heart transplantation. Medicine-take required may avoid or reduce rejection.

Objective To evaluate the usefulness of the short-segment nerve conduction studies (SSCSs,inching test) of the peroneal nerve across the fibular head in order to diagnose and localize the site of entrapment of the nerve.Methods Fifty-four patients with suspected peroneal nerve palsy and 30 controls were studied.The symptoms all occurred in unilateral leg,involving 25 left legs and 29 right legs.Both long segment motor nerve conduction studies (LSMCs) and SSCSs were performed in all patients and controls.SSCSs were obtained at 2 cm intervals,starting 6 cm proximal (P6,P4 and P2) and 4 cm distal (D2 and D4) ending to the fibular head prominence (P).Results When nerve conduction of the entire 10 cm segment across the fibular head was tested by the conventional method,only 40 showed reduction in amplitude or slowing of motor conduction velocity or both.However,with SSCSs,54 peroneal nerves were all discovered abnormal.The results of comparison of conventional methods suggested that there were significant differences in conduction velocity between the fibular head-Ankle segment and the knee-fibular head segment in the case group,the latter ((33.63 ± 9.29) m/s) being slower than the former ((47.92 ± 4.04) m/s;t =9.776,P =0.000),while there was no obvious abnormality in the control group.The results of the control group detected by SSCSs showed that there was no significant difference between the left and right sides of the mean amplitude of the stimulation points and the mean time of segmental nerve conduction.Therefore,we set the exception criteria as the segmental nerve conduction time is longer than the corresponding control group (i + 2 s),and the CMAP amplitude of proximal stimulation point decreased by more than 20％ than the adjacent distal segment.In accordance with this standard,we found that the lesions were located in P6 to P4 in 2/54 (3.7％) legs,P4 to P2 in 4/54 (7.4％) legs,P2 to P in 43/54 (79.6％) legs,P to D2 in 12/54 (22.2％) legs,D2 to D4 in 3/54 (5.6％) legs,respectively.Consequently,the P2 to P segment was most vulnerable to damage.Conclusions SSCSs are more sensitive in detecting the entrapment of the peroneal nerve across the fibular head than the LSMCs.SSCSs could precisely localize the entrapment lesions,might be a useful tool especially for the detection of mild entrapment which has normal LSMCs findings of the peroneal nerve across the fibular head.

Objective To investigate the alteration of apoptosis signal-regulating kinase 1(ASK1)phos-phorylation and matrix metalloproteinase-9(MMP-9)expression after temporal lobe epilepsy(TLE),and to explore the role and mechanism of ASK1-MMP-9 signal in TLE. Methods The lithium-pilocarpine epilepsy model was established. The ASK1 phosphorylation and MMP-9 expression were detected by western blot and immunofluo-rescence histochemistry. Using ASK1 inhibitors,the regulating effects of ASK1 on MMP-9 expression were deter-mined. And the role of ASK1 and MMP-9 in epileptic seizure was explored by inhibition of ASK1 and MMP-9. Results The ASK1 phosphorylation and MMP-9 expression increased in hippocampus in epilepsy model ,exhibiting a temporal correlation with epileptic seizure. Inhibition of ASK1 activation reduced the expression of MMP-9. And the level of epileptic seizure was significantly reduced by the inhibition of ASK1 and MMP-9. Conclusions The hippocampal ASK1 phosphorylation and MMP-9 expression distinctly increase in TLE model ,and the MMP-9 expression is induced by ASK1 activation. The ASK1-MMP-9 signal plays an important role in TLE.

Objective To observe the influence of Hemin on both the expression of neuroglobin (Ngb) and Tau protein phosphorylation in rats with vascular dementia (VD),and explore the effect and mechanism of Ngb in VD. Methods VD model was established in rats with a permanent bilateral common carotid arteries occlusion(2-VO). Fifty four healthy male SD rats were randomly divided into 3 groups:sham operation group,VD group and Hemin group. According to ischemic time,the animals in each group were randomly allocated into 1 week subgroup,4 weeks subgroup and 8 weeks subgroup(n=6 in each subgroup). The learning and memory ability of rats were evaluated by Morris water maze test. The brain histopathological changes were observed by HE staining and the expression of Ngb and phosphorylated Tau ( p-Tau) was de-termined by Western blot. Results Compared with the sham operation group,after 2-VO the escape latency extended (all P<0. 05) and cross-platform performance reduced in rats in both VD group and Hemin group (all P<0. 05). The learning and memory ability of rats in Hemin group was better than that in VD group at the corresponding time point:the increase in the number of crossing platforms(1 week:Hemin group (7. 00± 0. 89) times vs VD group (5. 50±1. 22) times,t=2. 42,P<0. 05;4 weeks:Hemin group (5. 33±0. 52) times vs VD group (3. 50±1. 04) times,t=3. 84,P<0. 01;8 weeks:Hemin group (6. 50±0. 55) times vs VD group (4. 50±1. 05) times,t=4. 14,P<0. 01). The expression of Ngb and phosphorylated Tau (p-Tau) increased in VD group and Hemin group (P<0. 01). Compared with VD group,the expression of Ngb in Hemin group was increased(1 week:Hemin group (3. 45±0. 23) vs VD group (2. 56±0. 08),t=5. 67,P<0. 01;4 weeks:Hemin group (3. 08±0. 13) vs VD group (2. 28±0. 08),t=7. 96,P<0. 01;8 weeks:Hemin group (2. 82± 0. 12) vs VD group (2. 05±0. 10),t=7. 28,P<0. 01),while p-Tau was decreased (1 week:Hemin group (1. 57±0. 12) vs VD group (2. 40±0. 15),t=7. 62,P<0. 01;4 weeks:Hemin group ( 2. 14±0. 21) vs VD group (3. 18±0. 14),t=8. 23,P<0. 01;8 weeks:Hemin group (1. 83±0. 13) vs VD group (2. 79±0. 19), t=4. 91,P<0. 01). In VD group and Hemin group,the learning and memory ability exhibited a negative cor-relation with Ngb (r=-0. 892,P<0. 01),whereas a positive correlation with p-Tau (r=0. 932,P<0. 01). Conclusion Hemin induces high expression of Ngb and inhibits Tau phosphorylation in VD rats. Ngb may play a neuroprotective role in the development of VD by regulating Tau phosphorylation.