BACKGROUND: Endothelium damage is the promoter of atherosclerosis, and endothelial progenitor cells as vascular endothelium precursor cells play an important role in endothelium repair and angiogenesis. The influence of statins on atherosclerosis through endothelial progenitor cells is the new research hot spot. OBJECTIVE: To summarize the research progress of statins through endothelial progenitor cells on atherosclerosis. RETRIEVAL STRATEGY: A computer-based search of Pubmed and Ovid database from January 2000 to December 2006, with the retrieval word of "endothelial progenitor cells, statins, atherosclerosis", and language was limited in English. Meanwhile CNKI and VIP database were retrieved from January 2000 to December 2006, the retrieval words were "endothelial progenitor cells, atherosclerosis, statins" in Chinese. Totally 62 articles were retrieved and checked primarily. Inclusive criteria: ①articles closely related to the influence of statins through endothelial progenitor cells on atherosclerosis;②articles published recently or in authorities journal were preferred in the same field. Exclusive criteria: repetitive research. LITERATURE EVALUATION: The mainly resource of documents is the influence of statins on atherosclerosis through endothelial progenitor cells. All 28 included documents were clinical or basic empirical studies, and 2 were reviews. DATA SYNTHESIS: Under physiological conditions, the integrity of the endothelial monolayer can be maintained by reproduction of adjacent cells. However, in conditions of oxidative stress damage, the integrity of the endothelium is prevented by progenitor cell homing.Statins mobilize endothelial progenitor cells to repair impaired endothelium and then postpone atherosclerotic progress. Statins mobilize endothelial progenitor cells through PI3K/Akt pathway and suppress endothelial progenitor cell apoptosis, leading to increase the number of endothelial progenitor cells in blood circulation, precipitate endothelial progenitor cells homing to myocardial ischemia site, promote new vascular generation, ameliorate blood supply of ischemia myocardium, and ameliorate the function of ventricular contraction. CONCLUSION: Through mobilizing endothelial progenitor cells, statins can increase the number of endothelial progenitor cells in blood circulation and suppress endothelial cells apoptosis, so as to postpone the progress of atherosclerosis, decrease the mortality rate of atherosclerosis patients, and improve their prognosis, which all indicate a wide research prospect.

Objective　To evaluate the safety and efficiency of percutaneous coronary interventions(PCI) in octogenarian Chinese with coronary artery disease.　Methods　A total of 43 patients aged over 80 years old underwent 45 such procedures at Queen Mary Hospital from October 1994 to May 1998. There were 27 male and 16 female 〔 mean age (82.3±2.5), range (80-89)〕. 55.8% of these patients had multi-vessel lesions. A total of 48 lesions in 43 patients was treated 〔25 LAD(52.1%), 11 LCX(22.9%) , 11 RCA(22.9%), 1 LM (2.1%)〕. 　Results　Thirty-seven (86.1%) patients were successfully performed PCI. Sixteen of them deployed stenting. Among the 6 lesions which failed to cross, 5 of lesions were LAD, 3 of them were total occlusion. The success rate and complication during the procedure were not significant difference compared with the control in 237 patients ＜80 years of age. At 18 months follow up, 78.5% of these patients was free or much improved of chest pain. The restenosis rate was 36.0% confirmed by coronary angiogram performed in 25 patients. 　Conclusions　In octogenarians with coronary artery disease PCI was a safe and effective procedure with a high successful rate, low acceptable complication rate and a favorable immediate and long term outcomes.

Objective To evaluate the effect of PTCA in patients younger than 40 years of age. Methods Patients aged 40 years or less who underwent PTCA were recruited. Clinical and angiographic data were reviewed. Results A total of 82 patients underwent such procedures. Successful PTCA were performed in 80 patients (97.56%), 93 lesions were treated (97.89%), resulting in an improvement in diameter stenosis from 84.5%?11.8% to 4.1%?1.2%. One patient (1.22%) required bypass surgery without death and Q-wave myocardial infarction. During 42.1?6.8 months′ follow-up, 3 patients died (non-cardial cause in two cases), 3 sustained a myocardial infaraction, and 1 required bypass surgery. 87.8% of patients were free of angina. The target vessel revascularisation rate (TVR) was 12.19%. Angiographic follow up were performed in 70 patients (8.4?5.2 months). The total restenosis rate was 31.43%, 13.16% in stent group. Conclusion Coronary angioplasty has a high immediate success rate and good long-term result when performed in young patients who can be treated safely and effectively with coronary interventions.

Objective To investigate operation time on biliary duct stone with acute gallstone pancreatitis.Methods The clinical data of 44 patients with acute gallstone pancreatitis who were admitted to Department of General Surgery,Taicang First People's Hospital for surgical management from January 2011 to December 2013 were retrospectively analyzed.Patients were divided into early surgery group and delayed surgery group according to the timing.Early surgery group was defined as the patients whose symptoms of pancreatitis were basically disappeared after conservative treatment and surgery was performed within two weeks,while delayed surgery group was defined as the patients who underwent surgery after two weeks.Results Of the 44 acute gallstone pancreatitis cases,18 patients were males,and 26 were females,with median age of 54 years old (range 26-83 years old).Forty-two cases were mild acute pancreatitis and the other two cases were severe acute pancreatitis.Preoperative imaging indicated both cholecystolithiasis and choledocholithiasis in 5 patients,cholecystolithiasis alone in 39 patients.The 5 patients underwent cholecystectomy and choledocholithotomy with T-tube drainage.Among these 5 cases,one patient with concomitant acute suppurative cholangitis had an emergency surgery,two patients with Ranson score ≤3 had early surgery,and two patients with Ranson score ≥4 had delayed surgery,and all the patients were cured and discharged.Thirty-nine cases with cholecystolithiasis alone were treated with laparoscopic cholecystectomy.Among the 39 patients,25 patients underwent early laparoscopic cholecystectomy,and the other 14 patients underwent delayed surgery,and all the patients were cured and discharged.When compared with delayed group,the average age and Ranson score of early group were lower [(46 ± 12) yrs vs (64 ± 11) yrs and (1.0 ± 0.5) vs (1.5 ± 0.8)],and the median hospital length of stay and the cost were significantly less in the early group than those in the delayed group [(14.0 ± 2.8) d vs (18.1 ± 3.3) d and (17 899 ± 3461) Yuan vs (23 710 ± 3230) Yuan],and the difference between the two groups was statistically significant (P＜0.05).Nevertheless,there was no difference between the operation time and recovery time.There was no conversion to open surgery or post-operative complication in the two groups.Conclusions For severe acute pancreatitis,the delayed operation is recommended when the symptom of pancreatitis is completely improved after conservative management,while for mild acute pancreatitis,early surgery does not increase operation difficulty and complication,and it can decrease the length of hospital stays and costs.

Objective To observe the effect of iodized oil on radiofrequency thermal ablation (RFA) of hepatic neoplasms by using a cluster array of ten separate electrodes. Methods The patients were divided into 2 groups, group A with transcatheter hepatic artery embolization, group B without transcatheter hepatic artery embolization. All patients were undergone radiofrequency ablation of hepatic neoplasms. Results The time of RFA for group A was (9?2.1) minutes, showing the diameter of necrosis of (5.3?1.4)cm. The time of RFA for group B was (1.6?4.6) minutes demonstrating the diameter of necrosis of (3.5?1.8)cm (P

Objective To evaluate the clinical application and mid-term result of Gore-Tex suture as an artificial chordae in mitral anterior leaflet valvuloplasty. Methods 38 patients with the anterior leaflet received surgery. The data of the cardiac function (EF), the diameter of left ventricular and left atria and the degree of mitral regurgitation were analyzed before and after operation. Results The degree of mitral regurgitation decreased significantly after operation. The mean degree of pre-operation mitral regurgitation was (3.76?0.43) +, and after surgery was (1.08?0.99)+,P

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.

BACKGROUND: Experiments have confirmed that there are integrin receptors on bone marrow mesenchymal stem cells (BMSCs), but it is still uncertain whether angiogenin-1(Ang-1) can promote survival of BMSCs and protest against its apoptosis via integrins. OBJECTIVE: To investigate the effect of human recombinant angiopoietin-1 on adhesion, vigour, anti-apoptosis of rat BMSCs and its mechanism of signal transduction. DESIGN, TIME AND SETTING: The cytological in vitro controlled study was performed at the Opening Laboratory, Zhongshan Hospital Affiliated to Xiamen University from January to October 2008. MATERIALS: A total of 40 clean Sprague Dawley rats were supplied by Shanghai Experimental Animal Center, Chinese Academy of Sciences. Human Ang-1 (R&D) was used in this study. METHODS: Combining density gradient centrifugation and adherence separation was used to separate, cultivate and identify rat BMSCs. At the third to sixth passages, BMSCs were used for this study. Various matrix was used to coat 24-well culture plates for 1 hour. Following washing, monoplast suspension was added. Seven groups were set up. Group 1 served as control, BMSCs were coated with phosphate buffered saline containing 0.1% bovine serum albumin. BMSCs in the groups 2, 3 and 4 were incubated with vitronectin, fibronectin and Ang-1. BMSCs in the groups 5, 6 and 7 were firstly incubated in ethylenediaminetetraacetic acid, ?1 antibody and RGD antibody for 10 minutes, and then placed in a 24-well plate, and coated with Ang-1. MAIN OUTCOME MEASURES: Adhesion, trypan blue staining method, MTT test, Hoechst staining and Annexin V/PI were used to measure biological effects of Ang-1 on adherence, activity and anti-apoptosis of BMSCs. Combined with integrin antibody and signal transduction blocker, the expression of phosphoserine/threonine protein kinase B (pAkt), total Akt, Bcl-2 and ?-actin was examined by western blotting. RESULTS: Rat BMSCs were successfully isolated. The purity of BMSCs was 98.3% using flow cytometry. Cell adhesion assay shows Ang-1 promoted the adhesion of BMSCs at 1, 2 and 3 days compared with control group (P

Objective To investigate the risk factors of nausea and vomiting syndrome after thyroidectomy.Method The clinical data of 214 patients undergoing thyroidectomy were analyzed retrospectively to look into the risk factors.Results Seventy-two patients contracted nausea and vomiting syndrome after thyroidectomy,with an incidence of 33.64%.All of them had nausea of degrees 1,2 and 3,taking up 47.22%,27.78%and 25.00%,respectively.38.89%of them had vomiting of mild,intermediate and severe degrees, accounting for 32.14%,57.14% and 10.71%,respectively.Gender,smoking history,anesthesia and surgical duration were correlated with the syndrome(All P<0.05).Non-conditional Logistic regression analysis showed that female,general anesthesia, operative duration ≥2h were independent risk factors(all P<0.05).Conclusions Syndrome of nausea and vomiting after hyroidectomy has a higher incidence.Female,general anesthesia and surgical duration are independent risk factors.Interventional measures pertinent to these factors may reduce the incidence of nausea and vomiting syndrome after thyroidectomy.