ObjectiveTo undertake a controlled, prospective study to investigate the relationship between serum resistin level and blood sugar, blood lipids and thyroid hormone in patients with hyperthyroidism. Methods Clinical data of 50 patients with hyperthyriodism were collected from 2008 to 2009 in department of endocrinology the Second Hospital of Harbin Medical University. All patients were newly diagnosed cases that received no medication. At the same time, 40 healthy persons underwent physical examination in the hospital were taken as control group. Diabetes, obesity, hypertension, and high cholesterol were excluded from the two groups. Serum resistin level was determined using ELISA method. Chemiluminescence was used to check the levels of fasting insulin, free triiodothyronine (FT3), free thyroxin (FT4), and thyroid stimulating hormone (TSH). Glucose oxidase method determination-peroxidase-anti-peroxidase(GOD-PAP) was used to check the levels of fasting blood-glucose.Cholesterol oxidase method was used to check the levels of total cholesterol(T-CH). Glycerol-phosphate oxidase was used to check the levels of triglyceride(TG). Enzymes colorimetric method was used to check high density level of lipoprotein cholesterol(HDL-C) and low density level of lipoprotein cholesterol (LDL-C), and the height, weight,waist circumference, and hip circumference were measured. Body mass index (BMI) and insulin resistance index (HOMA-IR) were calculated. Groups were compared using t test and correlation analysis using Pearson correlation test, and the relationship between serum resistin level and blood sugar, blood lipids and thyroid hormone were analyzed using multiple linear stepwise regression analysis method. Results Serum glucose[(5.2 ± 0.7)mmol/L],resistin concentrations[(132.1 ± 41.3)μg/L], FT3[(19.8 ± 8.7) pmol/L], FT4[(54.1± 29.6)pmol/L], fasting insulin levels[(7.9 ± 2.8)mU/L] and HOMA-IR(2.3 ± 1.0) were significantly higher compared with controls group [(4.7 ± 0.5)mmol/L, (65.1 ± 5.9)μg/L, (4.1 ± 0.6)pmol/L, (14.3 ± 2.2)pmol/L, (6.4 ± 2.7)mU/L, (1.5 ±1.2); t =4.64, 10.17, 11.42, 8.49, 4.48, 9.42, P＜ 0.01 or ＜ 0.05)]. T-CH[(3.7 ± 0.8) mol/L], LDL-C[(1.8 ±0.6)mol/L], TSH[(0.01 ± 0.01 )mU/L] were significantly lower compared with controls group[(4.6 ± 0.7)mol/L,(2.3 ± 0.7)mol/L, (1.80 ± 0.90)mU/L; t =5.30, 3.33, 14.48; all P＜ 0.01)]. Pearson correlation analysis showed that resistin and FT3, FT4 and HOMA-IR was positively correlated, respectively (r =0.719, 0.790, 0.396, P ＜ 0.01or＜ 0.05), resistin and T-CH and LDL was negatively correlated, respectively(r =- 0.364, - 0.519, P ＜ 0.05or ＜ 0.01). Multiple linear regression analysisshowed that resistin and FT3, FT4, and HOMA-IR was positively correlated, respeetively(r =0.756, P ＜ 0.01 ). Conclusion Resistin and FT3 and FT4 are related. Resistin might play important roles in insulin resistance and glucose and lipid metabolism disorders in patients with hyperthyriodism.

ObjectiveTo retrospectively analysis the role of intercostal artery reconstruction in spinal cord protection for patients with extent thoracoabdominal aotic aneurysm (TAAA) repair.MethodsFrom August 2003 to August 2010,extent Crawford Ⅱ TAAA repair were performed in 81 consecutive patients with mean age (39.4 ± 10.3) years and 61 (75.3％)were males.All the procedures were performed under profound hypothermia with interval cardiac arrest.Patientswere opened with a thoracoabdominal incision.Extracorporeal circulation was instituted with two arterial cannulae and a single venous cannula in the right atrium.T6 to T12 intercostal arteries and L1,2 lumbar arteries were formed to a neo-intercostal artery in place and were connected to an 8mm branch for keeping spinal cord blood perfusion.Visceral arteries were joined into a patch and anastomosed to the end of the main graft.Left renal artery was anastomosed to an 8mm branch or joined to the patch.The other 10mm branches were anastomosed to iliac arteries.ResultsWith 100％ follow-up,early mortality was 7.4％ (6/81),one patient was dead result from cerebral hemorrhage,three from renal failure,one from heart failure because of myocardial infarction and one from rupture of cliac artery dissection.Postoperative spinal cord deficits was 3.7％ (3/81),temporary paraplegia were observed in 2 patients and paraparesis occurred in 1 patient,but all of them were without bladder or rectum deficits.Neo- intercostal arteries were clogged in 12 patients within follow-up,and two of those patients with Marfan syndrome underwent pseudoaneurysm after intercostal arteries reconstruction.The mean survival time in this group is (54.22 ± 3.03 )months (95％ CI:44.37 months,59.90 months)with survival rate 92.37％ after 1 year,89.02％ after 2 years,85.54％ after 5 years.Three patient were dead with long term follow-up,one were resulted from cerebral hemorrhage at 20th month,one from rupture of ascending aorta at 23rd month and the last from rupture of aorta ulcer.ConclusionIntercostal artery reconstruction is a reliable method in spinal cord protection for patients with TAAA repair.It is a feasible method with acceptable surgical risks and satisfactory results.It can achieve long term result with less risk of spinal cord deficits and good quality of daily life.

Objective Retrospectively analyze the mid-term clinical results of single-stage repair of extensive aortic aneurysms with total or subtotal aortic replacement(T/STAR).This study describes our experience in this operation in single center of aortic disease at Fuwai Hospital.Methods From February 2004 to February 2011,21 patients with hypertension or Marfan syndrome underwent one-stage total or subtotal aortic replacement for aortic dissection or aortic aneurysms.16 male and 5 female,aged (34 ±9) years.Operations wore performed under circulatory arrest with profound hypothermia.Patients were opened with a mid-sternotomy and a thoracoabdominal incision.Extracorporeal circulation was instituted with two arterial cannulae and a single venous cannula in the right atrium.During cooling,the ascending aorta or aortic root was replaced.At the nasopharyngeal temperature of 20 ℃,the aortic arch was replaced with selective antegrade cerebral perfusion.Staged aortic occlusions allowed for replacement of descending thoracic and abdominal aorta.T6 to T12 intercostal arteries and L1,2 lumbar arteries were formed to a neo-intercostal artery in place and were connected to an 8 mm branch for keeping spinal cord blood perfusion.Visceral arteries were joined into a patch and anastomosed to the end of the main graft.Left renal artery was anastomosed to an 8mm branch or joined to the patch.The other 10 mm branches were anastomosed to iliac arteries.Results Early mortality was4.8％ ( 1/21 eases),the only one patient was dead result from renal failure and multiple organ failure.There were no postoperative spinal cord deficits occurred,two patients were stroked at day 5th and 7th respectively.Three patients were operated with tracheotomy because of respiratory insufficiency.Operation was undertaken on one patient with splenenctomy result of spleen rupture during first aortic aneurysms repair.All patients were follow-up,ranging from 18 to 84 months postoperatively,all 20 survivors were alive and had good functional status.One patient was reoperated with aortic valve replacement because of massive valve insufficiency after two years.Neo- intercostal arteries were clogged in 3 patients within follow-up,and two of those patients with Marfan syndrome underwent pseudoaneurysm after intercostal arteries reconstruction.Conclusion Single-stage repair of extensive aortic aneurysms with total or subtotal aortic replacement is safely and effectively.It is feasible with acceptable surgical risks and satisfactory results.It can eliminate the risk of remnant aortic aneurysm rupture in staged total aortic replacement and has satisfactory mid-term results.

Objective Retrospectively analyze 47 cases received reoperation with aortic disease after aortic valve replacement to deepen the understanding of aortic valve disease.Methods From January 2003 to June 2012,47 patients with previous aortic valve replacement received aortic root or other aortic operation because of new aortic disease.38 male and 9 female,the interval (6.0 ± 3.8) years. All cases with new aortic disease were diagnosed by cardiac ultrasound and aortic computed tomography.Bentall's procedure were operated on 14 patients,total aortic arch replacement with elephant trunk procedure on 14 patients,aortic root and aortic arch with elephant trunk procedure on 7 patients,ascending aortic replacement on 10patients,total thoracic and abdominal aorta replacement on 2 cases.All patients were followed by clinic interview or telephone.Results Aortic dissection and aneurysmal dilatation were occurred on ascending aorta,each account for 50％,in patients with previous aortic valve replacement because of rheumatic valve disease and bicuspid aortic valve; 3 cases with Marfan syndrome occurred ascending aortic dilatation and 4 cases occurred aortic dissection.Diameter in ascending aorta increased (5.2 + 7.1)mm per year and aortic sinus (3.3 ± 3.1)mm per year.The value of ascending aortic dilatation per year in patients with rheumatic disease was higher than patients with Marfan syndrome(P ＜ 0.05).47 patients were re-operated in fuwai hospital,1 patients died in operating room because aortic dissection seriously involved right coronary artery.7 patients have renal insufficiency after operation and all were cured by hemofiltration; neurological complication occurred in 14 patients including that 7 patients stroked and 7 patients had transient brain dysfunciotn.There were no postoperative spinal cord deficits occurred.All patients were followed up,the mean follow up time were(53.49 +33.79) months.8 cases were died during follow-up and threeyear survival rate was 83％.There were no cases received operation due to aortic disease during follow-up.Conclusion Deepening the understanding of aortic valve disease combine ascending aorta changes,especially pay attention to patients with previous aortic valve replacement because of Marfan syndrome and rheumatic disease during follow-up after first operation,all efforts should decrease the occurrence of aortic adverse events in long term.

BACKGROUND: Studies have shown that after bone marrow stem cell transplantation, there are juvenile cells with the episode of myocardial cells around the infarct areas, which was recognized as deriving from bone marrow stem cells.OBJECTIVE: To explore the homing situation of bone marrow stem cells by autologous mobilization around the infarct areas aftar myocardial infarction.DESIGN, TIME AND SETTING: The cytological in vitro study was performed at the China-Japan Clinical Pathology Center, Daliar Medical University from February 2005 to April 2006.MATERIALS: A total of 30 myocardial samples from the autopsy at the Department of Pathology and Forensic Medicine, Dalian Medical University between 2000 and 2005. Fifteen normal samples dyed from the mechanical injuries or craniocerebral injury,without abnormity following autopsy. Fifteen samples in the myocardial infarction group suffered from coronary atherosclerosis and coronary tube stenosis, and died within 10 days after myocardial infarction.METHODS: The autopsy was performed within 48 hours after the death and the tissues were obtained from antedor wall, lateral wall and posterior wall of the left ventricle, and made into tissue sections. We checked the expression of CD34, CD133 and transforming growth factor-β, in the normal area, infarct area and around the infarct area by immunohistochemistry.MAIN OUTCOME MEASURES: The expression of CD34, CD133 and transforming growth factor-β in different areas and the relationship between them.RESULTS: The positive expression of CD34 in infarct area was significantly stronger than that around the infarct area and in normal area (P < 0.01). The positive expression of transforming growth factor-β in infarct area was significantly stronger than that around the infarct area (P < 0.01), and the expression of transforming growth factor-β showed negative reactJon in normal area. The expression of CD34, CD133 and transforming growth factor-β, in infarct areas and around the infarct area was closely related (P < 0.01).CONCLUSION: There are the homing of bone marrow hemopoietic stem cells in infarct area and around the infarct ares after myocardial infarction. The increase in transforming growth factor-β in infarct area provides the possibility for the differentiation of the homing stem cells, the following angiogenesis and the regeneration of cardiomyocytes.

Objective Adenocarcinoma of the stomach has been established as a consequence of gastric infection with Helicobacter pylori(H.pylori).The specific role of H.pylori in the pathogenesis is unknown yet.Recent studies indicate that expression of mitogen inducible cyclooxygenase-2(COX-2) occurs in gastrointestinal tumors.The purpose of the present study was to investigate expression of COX-2 protein in the human stomach with or without H.pylori infection.Methods Twenty-seven subjects who were asymptomatic referred to the hospital for healthy examination including endoscopic screening.Biopsy specimens were obtained from the subjects without any macroscopic lesions,such as peptic ulcer or gastric malignancies.H.pylori infection was determined by rapid urease test(CLO test),bacterial culture and histology(Giemsa staining).Expression of COX-2 was evaluated by immunohistochemistry using the avidin-biotin-peroxide complex(ABC) method The association between COX-2 expression and H.Pylori infection was assessed by Fisher's exact test.A P value less than 0.05 was considered to be statistically significant.Results specific immunostaining for COX-2 was observed in antral mucosa of 18 subjects infected with H.pylori COX-2 was expressed in gastric mucosal epithelia,mainly in the foveolar epithelial cells.Furthermore,COX-2 was also observed in the neck cells of the gastric glands and inflammatory mononuclear cells beneath the mucosal epithelia.Expression of COX-2 was never found in the gastric mucosa of H.pylori-negative subjects.A positive association of H.pylori infection with COX-2 expression was statistically significant(P

Objective To evaluate the effects of Xin-ke-shu and Betaloc on arterial elasticity of coronary heart disease(CHD).Methods According to the results from coronary angiography,50 patients who were taking long-term treatment of coronary artery obstructions were enrolled and divided into two groups in equal number at random.They were divided into Xin-ke-shu group(n=25)and Betaloc group(n=25).The Xin-ke-shu group received Xin-ke-shu(12/d)individually and the Betaloc group received Betaloc(50mg/d)for eight weeks.Patient's heart rate was measured by the doctor.Brachial blood pressure was measured by standardized mercury cuff sphygmomanometer.Automatic pulse wave velocity(PWV)measurement system and Complior Colson device and DO-2020 were applied to examine the carotid-radial artery PWV(PWVcr)and the large arterial elastic indexes(C1 and C2)respectively.Results After eight weeks of treatment.All patient's heart rate showed significant decrease.The Betaloc group,after excluded the betaloc effect,showed significant decrease of blood pressure.The Xin-ke-shu group showed significant increase of C1 and C2,and PWVcr slowed down obviously.Conclusion Xin-ke-shu improves the small and large arterial elasticity,and attenuates the wave reflex amplitude.

We achieved satisfactory results in preventing post-colostomy cutaneous complications by targeted nursing interference.This article summarizes the experience in nursing three colorectal carcinoma patients against such complications after colostomy,with an analysis of the common causes of stomy-related cutaneous complications.

Objective To study the difference of galectin-3 and HBME-1 expression between benign and malignant thvreid nodules and to evaluate their clinical value.Methods Using immunohistochemical SP method,the paraffin-embedded tissues of 30 ewes papillary thyroid carcinoma(PTC)and 30 cases nodular goiter(NG) were examined to deteet the expression of Galectin-3 and HBME-1.Results The rates of positive staining of Galectin-3.HBME-1.Galectin-3 combined with HBME-1 in PTC were 93.3%(28/30),83.3%(25/30)and 100.0%(30/30),respectivdy,were higher than that of NG[20.0%(6/30),6.7%(2/30)and 26.7%(8/30)].There were significant differences between PTC and NG(X2＝32.85,35.65,34.74,all P＜0.01).The sensitivity,specificity,positive predietive value.negative predictive value and accuracy rate of using Galectin-3,HBME-1,Galectin-3 combined with HBME-1 in differentiation NG from FrIE were 93.3%,83.3%,100.0%;80.0%,93.3%,73.3%;82.3%,92.6%,78.9%:92.3%,84.8%,1 00%;86.7%,88.3%,86.7%,respectively.Conclusion Immunohistochemical stains of Galectin-3 and HBME-1 may be used as two lnarkel's for differentiating PTC and NG,it is especially sensitive when the two markers are jointly used.

Objective To investigate the effect of continuous positive airway pressure(CPAP)during one lung ventilation on pulmonary function in patients undergoing video-assisted thoracoscopic repair of atrial septal defect.Methods Twenty ASA Ⅱ patients of both sexes,aged 16-30 yr,weighing 41-64 kg,scheduled for video-assisted thoracoscopic repair of atrial septal defect,were randomly divided into 2 groups(n = 10 each): control group and CPAP group.One lung ventilation(VT 8 ml/kg,RR 12-16 bpm,I:E 1:2,PETCO2 35-40 mm Hg)was perform in both groups.CPAP(6 cm H2O)was perform during one lung ventilation in group CPAP.The oxygenation index,pulmonary compliance and airway pressure were recorded during operation.The cardiovascular events,hyoxemia and extubation time were recorded.Results The oxygenation index and pulmonary compliance were significantly higher,extubation time was shorter,and the incidence of hyoxemia was lower in CPAP group than in control group(P ＜ 0.01).The airway pressure was in the normal range in both groups.No cardiovascular events was found in both groups.Conclusion CPAP(6cm H2O)during one lung ventilation can improve the pulmonary function in patients undergoing video-assisted thoracoscopic repair of atrial septal defect.