Coronary Artery Bypass ; adverse effects ; Humans ; Male ; Middle Aged ; Radiodermatitis ; etiology

Objective To identify the risk factors associated with intraoperative acute cardiac decompensation in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods From November 2007 to February 2009, 2379 OPCABGs were performed in our hospital. The possible risk factors associated with intraoperative cardiac decompensation were retrospectively analyzed. The preoperative patient demographics and intraoperative characteristics were correlated with intraoperative acute cardiac decompensation.The possible risk factors included sex, age, body weight, cardiac function (NYHA classification), the associated diseases (hypertension, diabetes mellitus, liver-kidney dysfunction), history of myocardial infarct, ventricular aneurysm, preoperative treatment with β-blocker and/or calcium channel blocking agent, ventricular extrasystole,atrial fibrillation, duration of operation, etc. Results Three hundred and sixty-eight patients developed acute cardiac decompensation during OPCABG (15.5%). No patient died during operation. Multivariate analysis indicated that the risk factors for acute cardiac decompensation during OPCABG included left ventricular aneurysm valvular dysfunction, left main disease, history of myocardial infarct, preoperative ventricular premature beat,preoperative ejection fraction (EF) ＜ 40%, intraoperative atrial fibrillation, intraoperative frequent ventricular premature beat, tachycardia before anesthesia and emergency OPCABG. Conclusion The risk factors for acute cardiac decompensation during OPCABG includ left ventricular aneurysm valvular dysfunction, left main disease,history of myocardial infarct, preoperative ventricular premature beat, preoperative EF ＜ 40%, intraoperative atrial fibrillation, intraoperative frequent ventricular premature beat, tachycardia before anesthesia and emergency OPCABG.

Objective To investigate the effect of physical training on plasma N-terminal pro-brain natri- uretic peptide(NT-proBNP)levels in patients with chronic heart failure(CHF).Methods Eighty NYHAⅡ-ⅢCHF patients were randomly divided into a training group(n=42)and a control group(n=38).A 6-minute walk- ing test was performed within 24 hours after the patients were admitted.The 6-minute walking distance and plasma NT-proBNP levels were determined before and after 8 weeks of programmed physical training.The patients of both groups were treated with routine drugs for heart failure.6-minute walk training was only performed in the training group twice a day for 8 weeks.Results Physical training could significantly reduce plasma NT-proBNP levels and improve performance on the 6-minute walking test.Conclusions Physical training could significantly reduce plas- ma NT-proBNP levels and improve the motor function of patients with CHF,and could be helpful in delaying the de- velopment of CHF.

Objective To compare prospectively the features and effects of combined operation(splenorenal shunt plus portal-azygous devascularization) and portal-azygous devascularization only(PCDV)on portal(hypertension)(PH).Methods We summarized 360 cases of PH admitted from 1984 to 2004.All patients were randomly divided into two groups,one was combined operative group(250 patients) and the other was PCDV group(110 patients).The therapeutic effects and changes of portal hemodynamics were studied with doppler flowmeter(DCFI),free portal pressure(FPP) and digital subtraction angiography(DSA) pre-and post-operatively,and were measured directly during the course of the procedure.Results(1)Postoperative bleeding:Of all the patients who underwent combined operation,no case of rebleeding occurred in the short period after operation,and the rebleeding rate was 8.0% in the long period of follow-up.In the patients who underwent PCDV,the rebleeding rate was 5.5% in the short period after operation,and 17.6% at long-term follow up(P0.05).(3)There was a significant decrease in the diameter of portal vein,and FPP postoperatively in the combined operation group compared to PCDV group.There was a significant decreases of PVF in the PCDV group.But the decrease of PVF in the two groups had no significant difference.Conclusions The combined procedure has merits of greater decrease of FPP,and alleviation of the condition of hyperdynamic blood flow in the portal vein.The clinical effect is also better than that of portal-azygous devascularization only.

Objective To explore protective effect of Heme oxygenase-1(HO-1) on irradiation-induced endothelial cell apoptosis.Methods Human endothelial cell line EA.hy926 were administered with or without HO-1 activator Copp and/or HO-1 inhibitor Znpp,respectively.Then,cells were treated with or without 8 Gy radiation.The HO-1 protein expression of cells were assessed with Western blotting and apoptosis of cells treated with irradiation were evaluated with flow cytometry.Moreover,cytochrome C releasing into cytosol were also determined by Western blotting. Results In PBS+R group,HO-1 protein expression of EA.hy926 was low posterior to irradiation.When cells were preconditioned with Copp and/or Znpp,then recieved with 8Gy irradiation,the HO-1 protein expression of EA.hy926 increased significantly in comparision with the PBS+R group(P

Animals ; Cell Proliferation ; drug effects ; Cells, Cultured ; Comet Assay ; DNA Damage ; Dose-Response Relationship, Drug ; Lead ; toxicity ; Lymphocytes ; drug effects ; Male ; Mice ; Mice, Inbred Strains ; Spleen ; cytology ; drug effects ; Thymus Gland ; cytology ; drug effects

Objective To determine if the cardiac index (CI) measured with arterial pressure-based cardiac output (APCO) agrees with that measured with pulmonary artery catheter (PAC) during cesarean section in parturients with congenital heart disease and severe pulmonary hypertension.Methods Thirty parturients with congenital heart disease and severe pulmonary hypertension,scheduled for elective cesarean section,were enrolled in the study.APCO and PAC were used for cardiac output and other parameters of hemodynamics monitoring during operation in all patients.Continuous epidural anesthesia was performed.CI was recorded immediately before epidural administration (T1),at 5 and 10 min after epidural administration (T2-3),immediately before delivery (T4),and at 2 and 5 min after delivery (T5-6).The correlation was tested by Pearsone correlation analysis.CI derived from APCO and PAC was compared by Bland-Altman analysis for agreement.Results CI measured with PAC was significantly higher than that measured with APCO (P ＜ 0.05).Compared with the baseline value at T1,no significant difference in CI measured with PAC and APCO was found at T11-T4 and T6 (P ＞ 0.05),and CI measured with PAC and APCO was significantly increased at T5 (P ＜ 0.05).Bland-Ahman analysis showed poor agreement between CI measured with the two methods.The correlation analysis showed that there was positive correlation between CI derived from the two methods at T1-6 (the correlation coefficient was 0.93,0.95,0.94,0.89,0.96 and 0.91 at T1-6,respectively,P ＜ 0.05).Conclusion CI value obtained with APCO agrees poorly with that obtained with PAC during cesarean section in parturients with congenital heart disease and severe pulmonary hypertension,but agrees well in monitoring the changing trend of CI.

Objective To investigate mupiroein resistance in Staphylococcus aureus (SAU) and the resistance to commonly used antibiotics in mupirocin-resistant strains. Methods Four hundred and ninety clinically isolated SAU strains froin January 2005 to May 2007 in the First Affiliated Hospital,Wenzhou Medical College were screened by mupirocin(5μg)disc diffusion method.Minimum inhibition concentration(MIC)and the amplification of mupA gene were performed to determine the resistance to mupirocin.Resistance to cefoxitin,gentamycin, levofloxacin, trimethoprim/sulfamethoxazole, rifampin, erythromycin, clindamycin, tetracycline and vancomycin in mupirocin-resistant strains was detected by disc diffusion method, and the amplification of mecA gene was performed to confirm the methieillin resistance among mupiroein-resistant strains.Results Twenty-seven mupirocin-resistant strains were obtained,in which 22(81.5%)were hish-level mupirocin resistant(MuH)and the rest were low-level mupirocin resistant(MuL).Among 27 mupirocin-resistant strains,24 were methicillin-resistant Staphylococcus aureus (MRSA)in which 21 were MuH and 3 were MuL strains.Drug sensitivity tests showed that the resistance to gentamycin,levofloxacin,trimethoprim/sulfamethoxazole,rifampin,erythromycin,elindamycin and tetracycline were hish among MuH and MuL strains,and most of these strains were multi-drug resistant.All strains were susceptible to vaneomycin.Conclusions Most of the clinical emerged mupirocin-resistant SAU strains are MuH and show hish resistance to commonly used antibiotics.Therefore,detection and drug sensitivity test of mupirocin-resistant strains should be strengthened in clinic practice in order to prevent it from dissemination.

By studying the relationship between fingertip temperature changes and arterial function during vascular reactivity test, we established a new non-invasive method for detecting vascular function, in order to provide an assistance for early diagnosis and prevention of cardiovascular diseases. We customized three modules respectively for blood occlusion, measurement of finger temperature and blood oxygen acquisition, and then we established the hardware of data acquisition system. And the software was programmed with Labview. Healthy subjects [group A, n = 24, (44.6 ± 9.0) years] and subjects with cardiovascular diseases [group B, n = 33, (57.2 ± 9.9) years)] were chosen for the study. Subject's finger temperature, blood oxygen and occlusion pressure of block side during and after unilateral arm brachial artery occlusion were recorded, as well as some other regular physiological indexes. By time-domain analysis, we extracted 12 parameters from fingertip temperature signal, including the initial temperature (Ti), temperature rebound (TR), the time of the temperature recovering to initial status (RIt) and other parameters from the finger temperature signal. We in the experiment also measured other regular physiological body mass index (BMI), systolic blood pressure (SBP), diastiolic blood pressure (DBP) and so on. Results showed that 8 parameters difference between the two group of data were significant. based on the statistical results. A discriminant function of vascular function status was established afterwards. We found in the study that the changes of finger temperature during unilateral arms brachial artery occlusion and open were closely related to vascular function. We hope that the method presented in this article could lay a foundation of early detection of vascular function.
Adult ; Aged ; Arteries ; physiopathology ; Blood Pressure ; Cardiovascular Diseases ; diagnosis ; Fingers ; Humans ; Middle Aged ; Skin Temperature

Calcinosis ; complications ; Decalcification Technique ; Humans ; Meningeal Neoplasms ; complications ; Meningioma ; complications ; Specimen Handling ; methods ; Ultrasonics