The conception of evidence-based medicine (EMB) has a strong influence on the medical world since it built up.This concept has been widely used in all sorts of clinic and basic medical research,however,it is little reported to be practised in our fundamental medical education.As for it,this article will briefly analyze the importance of introducing the idea into fundamental medical education,and for one thing,suggest some more reform measures for medical teaching staff.

Posttraumatic foreign bodies in the heart or great vessels is rare, which may cause cardiac tamponade, bleeding, shock, infection, embolism, arrhythmia, valve dysfunction, etc. The foreign bodies can be removed by surgery or percutaneous intervention. In this report we reviewed our experience in managing posttraumatic foreign bodies in 13 patients at our institution from 1992 to 2002.
Adolescent ; Adult ; Aorta ; injuries ; Female ; Foreign Bodies ; etiology ; Heart Injuries ; complications ; Humans ; Male ; Middle Aged

OBJECTIVETo investigate whether myocardial bridging (MB) is independently associated with coronary atherosclerosis proximal to MB in the left anterior descending coronary artery (LAD) identified by computed tomographic coronary angiography (CCTA).

METHODSFrom March 2011 to December 2012, patients (n=9 862) with suspected coronary disease underwent CCTA using dual-source CT scanner. The baseline clinical characteristics (age, gender, smoking history, presence of hypertension, dyslipidemia, diabetes mellitus, family history of heart attack, and body mass index) and the results of CCTA were reviewed. Two radiologists evaluated the coronary artery for MB and coronary atherosclerosis stenosis (CAS) in LAD and made a diagnosis by consensus. Significant independent risk factors for CAS were investigated by multivariate logistic regression analysis.

RESULTSA total of 3 182 (32.3%) cases of MB and 3 359 cases of CAS of LAD were identified. No patient with CAS in the tunneled segment was found. The mean length of bridges and the mean thickness of the overlying myocardium was (17.3±5.2) mm and (1.2±0.9) mm, respectively. There were 1658 MB cases in 3 359 cases of LAD stenosis and 1 524 MB cases in 6 503 cases of no LAD stenosis (χ(2)=681.12, P<0.05). Logistic regression analysis showed that MB in the LAD were significantly associated with CAS in the proximal LAD (OR=3.07, 95%CI=2.81-3.37, P<0.001), and after final adjustment for age, gender, body mass index, family history of heart attack, smoking, hypertension, dyslipidemia, diabetes mellitus, and resting heart rate (OR=2.86, 95% CI=2.60-3.16, P < 0.001).

CONCLUSIONMB in the LAD is independently associated with CAS in the proximal segment to MB.

Adult ; Aged ; Aged, 80 and over ; Coronary Stenosis ; complications ; diagnostic imaging ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Myocardial Bridging ; complications ; diagnostic imaging ; Risk Factors ; Tomography, X-Ray Computed

To develop Students' Practical Ability according to the teaching requirement and culture aim of preventive medicine major,the teaching plan,teaching content,teaching methods,and experimental check-ing methods were explored and the experimental teaching pattern of medical microbiology adapted to pre-ventive medicine major was constructed.The investigation showed that the experimental teaching pattern helped to cultivate the students' operating ability,thinking of scientific research and ability of aggregate and solving analysis.Moreover,it helped to develop the students' co-operative consciousness and team spirit.It indicated that the new pattern was superior to the traditional experimental teaching.

The aim of this study is to explore the tissue distribution of PEGylated puerarin in acute myocardial ischemia model rats. Healthy male SD rats were randomly divided into two groups (30 each). Both were given PEGylated puerarin at a dose of 488 mg x kg(-1). After 5 min of medication, one group was normal rats, another group with acute myocardial ischemia was established by peritoneal injection of 50 mg x kg(-1) isoprenaline. After administration, the animals were executed at 30, 60, 90, 120, 150 and 180 min, then heart, liver, spleen, lung, kidney were extracted. The content of puerarin in organ tissue was determined by HPLC. The results showed that the AUC of tissue distribution of PEGylated puerarin in normal rats was liver > kidney > heart ≈ spleen > lung > brain. While the AUC of tissue distribution of PEGylated puerarin in acute myocardial ischemia model rats was liver ≈ heart > kidney > lung ≈ spleen > brain. AUC(heart) of PEGylated puerarin in acute myocardial ischemia model rats was 1.7 times than that of the normal rats, and there was significant difference (P < 0.05). Thus, PEGylated puerarin had a good heart-targeting property in early myocardial infarction area, drugs could accumulate in the ischemic myocardium. It provided important information for further study and clinic use of PEGylated puerarin.
Animals ; Brain ; metabolism ; Isoflavones ; pharmacokinetics ; Kidney ; metabolism ; Liver ; metabolism ; Lung ; metabolism ; Male ; Myocardial Ischemia ; metabolism ; Myocardium ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spleen ; metabolism ; Tissue Distribution

OBJECTIVETo investigate the effects and mechanisms of panaxoside Rg1 on the new vessel formation in acute myocardial infarction (AMI) rats.

METHODSThe AMI model of male Sprague-Dawley (SD) rats was established, and rats were randomly divided into the AMI model group, the treatment group of panaxoside Rg1, the placebo group and the treatment group of panaxoside Rg1 plus rapamycin. Cardiac creatases were determined with 1 mL blood drawn from vena caudalis of the rats 48 h after the model was successfully made. After 4 weeks, Evans blue was injected into the aorta roots of the rats, and then, red tetrazoline was dyed again and the myocardial infarction area was evaluated. The microvessel density (MVD) of infarction area was determined by the immunohistochemistry of CD31; enzyme-linked immunosorbent assay (ELISA) was used to detect the protein content of CD31 and hypoxia inducible factor-1alpha (HIF-1alpha) of the infarction area.

RESULTSThe MVD in the infarction area and the contents of CD31 and HIF-1alpha in the Rg1 treatment group were higher than those in the AMI model group significantly (P<0.05). The cardiac creatase and infarction area were lower in the Rg1 treatment group than those in the AMI model group significantly (P<0.05). The above effects, however, disappeared when rapamycin, the antagonist of mammalian target of rapamycin (mTOR), was administered simultaneously.

CONCLUSIONSPanaxoside Rg1 could increase the expression of HIF-1alpha and CD31 of myocardium and stimulate the angiogenesis. The above mentioned role of panaxoside Rg1 might be related to the excitation of mTOR receptor.

Animals ; Cell Count ; Collateral Circulation ; drug effects ; Drug Evaluation, Preclinical ; Ginsenosides ; administration & dosage ; pharmacology ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Intracellular Signaling Peptides and Proteins ; metabolism ; physiology ; Male ; Microvessels ; pathology ; Myocardial Infarction ; drug therapy ; metabolism ; pathology ; Neovascularization, Physiologic ; drug effects ; Placebos ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Protein-Serine-Threonine Kinases ; metabolism ; physiology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; drug effects ; Sirolimus ; administration & dosage ; pharmacology ; TOR Serine-Threonine Kinases

OBJECTIVETo investigate whether the major histocompatibility complex class I chain-related gene A gene (MICA) polymorphism and serum soluble MICA level were associated with the occurrence and development of colorectal cancer.

METHODSDNA samples from 117 colorectal cancer patients and 113 healthy individuals from Yangzhou in Jiangsu province were genotyped by using the polymerase chain reaction (PCR) and sequence-specific primer (SSP) method and PCR based sequencing. In addition, polymorphism at position 129 was also analyzed by PCR-SSP. Serum levels of soluble MICA were measured by a sandwich ELISA method.

RESULTSNeither the extracellular nor the transmembrane region polymorphisms of MICA gene were associated with the occurrence and the different stages of colorectal cancer. In contrast, the frequency of the methionine residue at position 129 was significantly decreased in the patient group. Soluble MICA levels in sera were increased in the late stages of colorectal cancer.

CONCLUSIONAlthough there was no genetic susceptibility attributed to MICA gene polymorphism with regard to development of colorectal cancer, serum levels of soluble MICA may be a diagnostic marker of advanced stages.

Colorectal Neoplasms ; blood ; genetics ; Enzyme-Linked Immunosorbent Assay ; Female ; Genotype ; Histocompatibility Antigens Class I ; blood ; genetics ; Humans ; Male ; Polymerase Chain Reaction ; Polymorphism, Genetic ; genetics

Traumatic tricuspid valve insufficiency (TTVI) is a relatively uncommon disease. To summarize the experience in the diagnosis and treatment of TTVI, we have analyzed the clinical data of 3 patients with TTVI who were admitted to the department of cardiac surgery of our hospital between April 1997 to April 2002. Relevant literatures have also been reviewed.
Accidents, Traffic ; Adult ; Cardiac Surgical Procedures ; methods ; Electrocardiography ; Follow-Up Studies ; Heart Injuries ; diagnosis ; surgery ; Heart Valve Prosthesis ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Multiple Trauma ; physiopathology ; Risk Assessment ; Sampling Studies ; Treatment Outcome ; Tricuspid Valve Insufficiency ; diagnosis ; surgery

OBJECTIVETo summarize the clinical experience of Bentall operation combined with total arch replacement and stented elephant trunk implantation for serious Debakey I aortic dissecting aneurysm.

METHODSTwelve patients with serious Debakey I aortic dissecting aneurysm underwent surgical treatment from January 2005 to December 2007. There were 10 male and 2 female with the mean age of (40.1 +/- 9.5) years old. There were acute aortic dissection in 9 cases, chronic aortic dissection in 3 cases. The inner diameter of aorta was (5.3 +/- 1.8) cm. There were Marfan syndrome in 4 cases, aortic regurgitation in all cases, severely persistent chest pain in 9 cases, acute left heart failure in 8 cases, and cardiac tamponade in 4 cases. Bentall operations combined with total arch replacement and stented elephant trunk implantation were performed by using deep hypothermic circulatory arrest and antegrade selective cerebral perfusion in all cases.

RESULTSUrgent surgery underwent in 9 cases. The mean interval between the onset of aortic dissection and the accomplishment of surgery was (41.0 +/- 15.9) hours. Cardiopulmonary bypass time was (191 +/- 26) min, average cross clamp time was (134 +/- 31) min, and average deep hypothermic circulatory arrest time was (50.0 +/- 14.5) min. One patient died in hospital. The time stayed in ICU was 3 to 27 d. Mental disorder in 6 cases, hemi-paralysis in 1 case, amputation in 1 case, hemorrhage of anastomosis in 1 case, hemorrhage of alimentary tract in 1 case, and pleural effusion in 4 cases were recorded. Eleven cases were followed-up for 8 weeks to 36 months. There were no bending of the stents and no obstruction in the vascular prosthesis.No re-operation was needed. One case died 6 months postoperatively.

CONCLUSIONBentall operation combined with total arch replacement and stented elephant trunk implantation is safe and effective for serious Debakey I aortic dissecting aneurysm, while good organs protection and consummate cardiopulmonary bypass were taken.

Adult ; Aneurysm, Dissecting ; surgery ; Aorta ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Blood Vessel Prosthesis Implantation ; Circulatory Arrest, Deep Hypothermia Induced ; Female ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome

OBJECTIVETo investigate myocardial protection and prognosis of the different operative procedures of coronary artery bypass grafting (CABG) for the senile patients with coronary artery disease.

METHODSFrom July 2008 to June 2009, 125 cases (age ≥ 65 years old) underwent CABG were divided into 3 groups.Group A (70 cases) undertook off-pump CABG, group B (33 cases) undertook on-pump beating heart CABG. group C (22 cases) undertook on-pump CABG with cardiac arrest. Serum level of cardiac troponin I (cTnI) and creatine kinase MB isoenzyme (CK-MB) activity were examined right before operation and 0, 24, 72 and 168 h after operation. The complications during perioperative period and the mortality were investigated.

RESULTSNo significant difference was found in the right before operation and 168 h after operation of the serum level of cTnI and CK-MB in the 3 groups (P > 0.05). The serum level of cTnI and CK-MB activity of group A was the lowest and group B was lower than group C. Group A was the best concerning the complications during perioperative period. The mortality of group A was lower than group B but no significant difference was found in the mortality between group A and C. No significant difference was found in the complications during perioperative period and the mortality between group B and C.

CONCLUSIONOff-pump CABG could reduce myocardial injury and the complications during perioperative period in the senile patients.

Aged ; Aged, 80 and over ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; methods ; Coronary Artery Bypass, Off-Pump ; Coronary Disease ; surgery ; Female ; Humans ; Male ; Prognosis