Objective To investigate the feasibility of minimal access valve surgery. Methods The authors performed minimal access valve surgery from January 1997 to January 2003 in 72 cases: 36 cases of mitral valve operations and 9 cases of tricuspid valve operations were performed through right anterolateral thoracotomy; 5 cases of aortic valve operations through mini-sternotomy approach; 5 cases of aortic valve operations and 2 cases of mitral valve operations through para-sternotomy approach; 15 cases of mitral valve operations through “reversed L” mini-sternotomy access. Results In the early course following the surgery (within 1 postoperative month ) 71 patients survived and 1 patient died of acute hepatic and renal failure.Complete follow-up in 64 patients for 6～60 months(mean, 13 months) revealed that all the patients responded symptomatically, with New York Heart Association (NYHA) Class Ⅱ status in 56 patients and Class Ⅲ in 8 patients. Color ultrasonocardiogram revealed normal status of mechanical or biological valves. All the patients were satisfied with cosmetic results. Conclusions Minimal access valve surgery is feasible, and is also associated with a better outcome in terms of sternal stability and postoperative recovery.

Objective By analyzing the epidemiological characteristics of brucellosis in Shanxi Province,to provide a scientific basis in formulation of strategies for effective prevention and control of the disease.Method Surveillance data of human brucellosis from China Information System for Disease Control and Prevention between 2004 and 2013 were statistically analyzed by descriptive epidemiological method.The regional,time,age and sex,occupational distribution of brucellosis were analyzed.The prevalence trend of brucellosis in Shanxi Province was summarized.Results From 2004 to 2013,the total incidence presented a rising tendency and the highest reported incidence was 19.10/10 million in 2013.A total of 43 061 cases of brucellosis occurred in Shanxi Province.The average incidence of brucellosis was 12.52/10 million.Regional distribution range was relatively focused on the north areas of Shanxi Province,the number of reported cases of Datong City was the largest (12 157 cases),being 28.23％.The incidence of Shuozhou City was the highest (42.97/10 million).The epidemic was spreading through all county areas.The disease was found each month throughout the year,the obvious incidence peak seasons were between March and June.The disease was most commonly found in 15-64 age groups(87.19％,37 545/43 061).Occupation distribution of patients was mainly farmers (83.34％,35 887/43 061).Conclusions The situation of brucellosis epidemic in Shanxi Province is relatively serious;the reported incidence of brucellosis in Shanxi Province is in a rapid upward trend year by year,even highly active in some particular areas.Different regions should establish regional mechanisms for joint prevention and control and implement different prevention and control measures to comprehensively and sequentially control brucellosis.

Objective To explore the effect of high fat diet on serum biochemical parameters and histopathology of main organs in Mongolian gerbils.Methods Forty-eight healthy adult male Mongolian gerbils were randomly and equally divided into model and normal groups.The gerbils in the model group were fed with high fat diet while the normal group with standard diet.Eight gerbils in each group were killed at the end of 4th,8th and 16th week,respectively,and the body weight, serum levels of Glu, TG, CHOL, HDL-C, LDL-C, UA, CREA, BUN, TBil, TP, ALB, ALT, AST and AMS were determined.The histopathological changes of main organs were observed.Results Compared with the normal group,the blood lipid of the model gerbils was significantly increased, the liver function was impaired, the blood uric acid level was higher, and the blood glucose was decreased at the end of 16th week.The AMS was increased at the end of 16th week,but the renal function showed no significant changes.The liver tissue of the model group gradually showed steatosis, inflammation, fibrosis and cirrhosis, accompanied by splenomegalia. The lung tissue and myocardium showed fatty degeneration and obvious damages in the later period,the pancreatic islets were enlarged and the amount of endocrine cells was increased,and the small intestine and kidney didn’ t show any distinct changes.Conclusions A gerbil models of hyperlipidemia and nonalcoholic steatohepatitis and cirrhosis can be well established by high fat diet feeding,and may serve as good models for research of hyperlipidemia-related hyperuricemia, and lung and myocardial damages.

Objective To investigate the changes in serum level of myocardial enzymes in patients with primary hypothyroidism and to evaluate the relationship between the level of those enzymes and clinical or experimental parameters.Methods We measured several myocardial enzymes in serum of 108 patients with primary hypothyroidism including 31 cases of Hashimoto's thyroiditis,28 cases of atrophic thyroiditis,24 cases of Graves' hyperthyroidism treated by 131I,and 25 cases of Graves' hyperthyroidism treated by antithyroid drugs,as well as 50 normal controls.Results All the myocardial enzymes,including creatine kinase(CK) and its isoenzyme CK-MB,aspartate aminotransferase(AST),lactate dehydrogenase(LDH) and its isoenzyme HBDH,especially CK,were elevated in serum of patients with hypothyroidism.In addition,significant negative correlations were found between CK and FT3,CK and FT4,CK-MB and FT3,CK-MB and FT4.No difference in enzyme level was found among different hypothyroidism groups.Conclusion Hypothyroidism may cause elevation of myocardial enzymes in serum of the patients.The degree of CK and CK-MB increase was associated with the severity of hypothyroidism,and thus can be regarded as indexes to determine the severity of hypothyroidism.

Objective To investigate protection by immunization with recombinant Ferritin vaccine of Echinococcus granulosus against protoscolices.Methods ICR mice were randomized into 3groups of 12 mice in each.The mice in group A and B were immunized three times with an interval of two weeks and those in group C did nothing.The animals in all the 3 groups were challenged with 1100 protoscolices intraperitoneally on the 8th week.Serum samples were collected before each inoculation and challenge injection.Seven months later, all the mice were killed and examinated for hydatid cysts.Result The number of cysts was significantly lower in the group A than in group B and C (P＜0.05).The levels of protection afforded were found to be 73% and 85%, respectively.Meanwhile,the number of cysts was markedly lower in group B than in group C(P＜0.05).The rate of protection afforded was 42%.Conclusion Recombinant Ferritin vaccine of Echinococcus granulosus shows partial immune protection.Therefore, it might be a suitable candidate for cocktail vaccine study in the future.

Objective: To compare the efifcacy between emergent and delayed stent implantation in patients with ST-elevation myocardial infarction (STEMI) after thrombus extraction.
Methods: A total of 82 STEMI patients who received thrombus extraction and intracoronary injection of tiroifban, sodium nitroprusside, nitroglycerin via thrombus extraction catheter and with recovered TIMI 3 lfow from 2012-11 to 2014-01 were retrospectively studied. The patients were randomized into 2 groups by SAS software: Emergent group, the patients received stent implantation immediately upon diagnosis and Delayed group, the patients were treated by anti-platelet and anticoagulant medication for 10-14 days, and then received stent implantation. n=41 in each group. The primary and secondary indicators were compared between 2 groups which including ST-segment resolution (STR), the occurrence rate of no-relfow/slow-relfow, myocardial blush grade (MBG) 3, parameters of stent, ventricular remodeling condition, the incidence of major adverse cardiac events (MACE).
Results: ①Delayed group had the post PCI STR at (68.2 ± 9.2)%, TIMI 3 grade at 97.5%, MBG 3 at 69.0%and corrected TIMI frame count (CTFC) at (19.5 ± 5.2), compared with Emergent group, P<0.05. The occurrence rate of no-relfow/slow-relfow in Delayed group and Emergent group were 2.5% and 31.0%, P<0.01. ②The parameters of stents in Delayed group and Emergent group were as the number at (1.21 ± 0.32) vs. (1.76 ± 0.76), the mean length at (28.3 ± 11.7) mm vs. (33.7 ± 12.9) mm, the mean diameter at (3.17 ± 0.76) mm vs. (2.82 ± 0.87) mm, all P<0.01. Delayed group had the higher dilating pressure than that in Emergent group, (18.5 ± 6.2) atm vs (13.6 ± 7.1) atm, P<0.01, and more patients in Delayed group receive high-pressure non-compliant balloon dilation 75% vs 23.8%, P<0.01. ③With 6 months of follow-up study, there were slightly declining trend for LVEF and LVSF in both groups than that at 1 week condition, P>0.05, while LVEDV and LVEDD increased than 1 week, P<0.05, the changes were more obvious in Emergent group, P<0.05. Delayed group had less MACE occurrence, P<0.05.
Conclusion: Delayed stent implantation in STEMI patients after thrombus extraction had reduced incidence of post PCI no-relfow/slow-relfow phenomenon, improved myocardial reperfusion and less MACE occurrence.

ObjectiveToexplorethedynamicchangesofoxidativestressandcytokinesinMongoliangerbilswith nonalcoholic fatty liver disease ( NAFLD) and their significance.Methods Forty-eight healthy male gerbils were randomly divided into normal group and model group , 24 in each group .Gerbils of the model group were fed with high fat diet while those of the normal group with normal diet .Eight gerbils in each group were killed at the end of 4 w, 8 w and 16 w, respectively .MDA content and SOD , GSH-PX and T-AOC activity in the liver tissue were detected by chemical method, and serum TNF-α, INF-γand IL-10 levels were determined using liquid suspension chip .Results With the development of NAFLD , MDA content in liver increased gradually , and the MDA contents were all significantly higher than those of the normal group ( P<0.01 ); T-AOC level slightly increased , and then decreased , the levels at 4 w and 16 w were markedly decreased compared with those of the normal group (P<0.05);SOD level was significantly increased and then markedly reduced, the level of the model group at 4 w was significantly increased (P<0.05), while that at 8 w and 16 w were significantly decreased (P<0.05, P<0.01).The level of GSH-PX was decreased gradually , the levels at 8 w and 16 w were significantly lower than those of the normal group (P<0.05).With the progression of NAFLD,serum TNF-αand IFN-γwere increased gradually , while the level of IL-10 decreased gradually , and the levels at 8 w and 16 w were significantly lower than those of the normal group ( P <0.05, P <0.01).Conclusions The oxidative stress-related indicators and inflammatory cytokines in the gerbil NAFLD models induced by high fat diet are significantly changed as simple fatty liver develops into steatohepatitis , liver fibrosis and cirrhosis , and participate in the development and progression of NAFLD .

BACKGROUND: Autologous vein transplantation is a common means for clinical treatment of coronary atherosclerotic heart disease. Identification of basic pathological changes of autologous vein transplantation will provide basis for further studies on how to protect transplanted vein and reduce the possibility of restenosis of transplanted vein.OBJECTIVE: This study was designed to investigate effects of hyperlipemia, an independent influential factor, on venous endothelial functions and histomorphology.DESIGN, TIME AND SETTING: This study, a randomized controlled animal experiment, was performed at the key laboratory of Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University of Chinese PLA.MATERIALS: A total of 50 healthy adult male rabbits were randomly and equally divided into a control group and a hyperlipemia group.METHODS: In the control group, rats were daily fed with normal diet 100-120 g. In the hyperlipemia group, rats were daily fed with normal diet 100-120 g plus cholesterol 1g. For all rats, water was freely available.MAIN OUTCOME MEASURES: Prior to and 2,4,8, and 12 weeks after feeding, blood sample and cervical vein specimens were taken for detection of blood lipid levels and observation of endothelial nitricoxide synthase (eNOS)expression, nitric oxide (NO) production, and histomorphologic change. Prior to harvesting vein sample, blood flow of jugular vein and carotid artery was examined using ultrasonic Doppler flowmeter. Simultaneously, histopathological changes including the thickness of intima and media, the diameter of the veins, and the presence of lipid or atherosclerotic plaque were observed.RESULTS: Eight weeks after feeding, blood lipid levels in the hyperlipemia group were significantly higher than those prior to feeding and in the control group (P<0.01), and maintained at this level. Obvious lipid plaques formed in the carotid artery of rabbits in the hyperlipemia group. Eight and twelve weeks after feeding, eNOS expression levels and NO production in the jugular veins were lower than those prior to feeding and in the control group (P<0.05). Simultaneously, endothelial denudation was noticed and the elastic fibers almost disappeared in the hyperlipemia group; there were no foam cells or lipid plaques.CONCLUSION: Hyperlipemia may result in endothelium dysfunction and histomorphological change of venous conduit.Nevertheless, autogenous vein transplanted into artery system, will greatly influence the remodeling of transplanted vein,even lead to restenosis of transplanted vein.

A rapid, sensitive and simple liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed for the simultaneous determination of yogliptin and its metabolite in Wistar rat plasma. Linagliptin and dexamethasone were chosen as the internal standards of yogliptin and its metabolite, (R)-8-(3-hydroxypiperidine- -yl)-7-(but-2-yn-1-yl)-1-((5-fluorobenzo[d]thiazol-2-yl)methyl)-3-methyl- H-purine-2, 6 (3H, 7H)-dione, respectively. After a simple protein precipitation using acetonitrile as the precipitating solvent, both analytes and ISs were separated on a Grace Altima HP C18 column (2.1 mm x 50 mm, 5 microm) with gradient elution using methanol (containing 0.1% formic acid, 4 mmol x L(-1) ammonium acetate)-0.1% formic acid (containing 4 mmol x L(-1) ammonium acetate) as the mobile phase. A chromatographic total run time of 4.4 min was achieved. Mass spectrometric detection was conducted with electrospray ionization under positive-ion and multiple-reaction monitoring modes. Linear calibration curves for yogliptin and its metabolite were over the concentration range of 0.5 to 500 ng x mL(-1) with a lower limit of quantification of 0.5 ng x mL(-1). The intra- and inter- assay precisions were all below 14%, the accuracies were all in standard ranges. The method was used to determine the concentration of yogliptin and M1 in Wistar rat plasma after a single oral administration of yogliptin (27 mg x kg(-1)). The method was proved to be selective, sensitive and suitable for pharmacokinetic study of yogliptin and M1 in Wistar rat plasma.

Objective To explore the relationship between blood glucose level and blood pressure variability in hypertensive patients. Methods A total of 125 hypertensive patients hospitalized in the department of cardiology in our hospital during May 2015 to October 2016 were retrospectively analyzed. Patients were divided into hypertension with diabetes mellitus group (n=59) and hypertension without diabetes mellitus groups (n=66). Data of blood pressure, blood pressure variability and blood glucose levels were analyzed in the two groups. Results (1) Hyperlipidemia, low density lipoprotein and cholesterol levels were significantly lower in the hypertension with diabetes mellitus group than those of hypertension without diabetes mellitus group. Level of glycosylated hemoglobin (HbA1c), 24 h diastolic pressure variability coefficient (24 hDBPCV), daytime systolic blood pressure variability coefficient (dSBPCV), and daytime diastolic pressure variability coefficient (dDBPCV) were significantly higher in the hypertension with diabetes mellitus group than those of hypertension without diabetes mellitus group (P<0.05). (2) Spearman correlation analysis showed that hypertension with diabetes mellitus was positively correlated with 24 hDBPCV, dSBPCV and dDBPCV. (3) ROC curves of HbA1c for diagnosis of non-dipper blood pressure in hypertensive patients showed that the cut-off value of HbA1c was 5.85%and the area under curve was 0.692 (P<0.05). The sensitivity was 71.1% and the specificity was 63.7%. Conclusion The present results demonstrate that blood pressure variability is increased in hypertension patients with higher blood glucose. HbA 1c level has potential clinical value for diagnosis of non-dipper blood pressure in hypertensive patients.