Objective To investigate the effects of heart displacement on hemodynamics during off-pump coronary artery bypass grafting (OP-CABG) while the sites for anastomosis were being exposed. Methods Forty-seven patients of both sexes (36 male, 11 female) aged 50-82 years undergoing OP-CABG were enrolled in the study. Preoperative cardiac function was assessed : class Ⅱ in 22 patients; Ⅲ in 23 and Ⅳ in 2 according to NYHA classification.The mean ejection fraction was 0.55?0.14 before surgery.They received on average 3.2 grafts. Premedication consisted of intramuscular morphine 10 mg, midazolam 3-5 mg and scopolamine 0.3 mg.Before induction of anesthesia ECG and SpO2 were monitored and radial artery was cannulated for continuous direct BP monitoring. Anesthesia was induced with midazolam 0.1 nig?kg-1 , fentanyl 4?g?kg-1 and pancuronium 0.1 mg?g-1 iv.The patients were mechanically ventilated after tracheal intubation and PETCO2 was maintained at about 40 mm Hg. Anesthesia was maintained with isoflurane and 50%-60% N2O in O2 and intermittent intravenous boluses of fentanyl and pancuronium. Swan-Ganz catheter which can continuously monitor mixed venous blood O2 saturation (SvO2) was placed in pulmonary artery via right internal jugular vein. SvO2, cardiac output (CO), BP, pulmonary arterial pressure (PAP) and HR were continuously monitored. Right atrial pressure (RAP) and PAWP were measured intermittently. Cardiac index (CI),stroke index (SI),systemic vascular resistance index (SVRI),PVRI, left and right ventricular work index (LVWI,RVWI) and left and right ventricular stroke work index (LVSWI,RVSWI) were calculated. The hemodynamic parameters were recorded after induction of anesthesia before surgery (T1,baseline),before heart displacement (T2), while anastomosis to anterior descending branch was being made (T3), while anastonosis to right coronary artery or posterior descending branch (T4) and to left circumflex artery or diagonal branch (T5) was being made, after normal heart position was resumed (T6) and at the end of operation (T7). Results While anastomosis to the anterior descending branch was being made (T3) SI and LVSWI significantly decreased as compared with the baseline (P

OBJECTIVETo observe clinical therapeutic effect of acupuncture combined with Yizhi Jiannao Granules for treatment of Alzheimer's disease and its effects on intelligence, daily life and social activity ability.

METHODSEighty-four cases were randomly divided into 3 groups, 28 cases in each group. The combined acupuncture and medication group was treated with acupuncture at Baihui (GV 20), Sishencong (EX-HN 1), Dazhui (GV 14), Guanyuan (CV 4), etc. and oral administration of Yizhi Jiannao Granules; the Chinese herb group was treated with Yizhi Jiannao Granules, and the western medicine group with oral administration of Aricept. The scores for the Mini-Mental State Examination (MMSE), Ability of Daily Life (ADL) and the therapeutic effects were assessed and compared before treatment and after treatment for 12 weeks among the groups.

RESULTSAfter treatment, the scores for MMSE and ADL were improved in the combined acupuncture and medication group, the Chinese herb group and the western medicine group, which were better in the combined acupuncture and medication group (P < 0.05). The total effective rate of 85.7% in the combined acupuncture and medication group was better than 71.4% in the Chinese herb group and 67.9% in the western medicine group.

CONCLUSIONAcupuncture combined with Yizhi Jiannao Granules has a significant therapeutic effect on Alzheimer's disease, which is better than that of Yizhi Jiannao Granules or Aricept.

Acupuncture Points ; Acupuncture Therapy ; methods ; Administration, Oral ; Aged ; Alzheimer Disease ; psychology ; therapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Humans ; Indans ; administration & dosage ; therapeutic use ; Male ; Middle Aged ; Nootropic Agents ; administration & dosage ; therapeutic use ; Piperidines ; administration & dosage ; therapeutic use ; Quality of Life ; Treatment Outcome

OBJECTIVETo obtain highly efficient small interfering RNAs (siRNAs) against bone morphogenetic protein-7 (BMP-7) for future functional analysis of BMP-7 in bone homeostasis.

METHODSWe designed 4 independent siRNA sequences against rat BMP-7 and transfected them in rat umbilical vein endothelial cells. After 72 h, we examined BMP-7 mRNA and protein level in the transfected cells using real-time PCR and Western blotting, respectively.

RESULTSAll the 4 siRNAs effectively reduced BMP-7 expression in rat umbilical vein endothelial cells, and among them BMP-7-3 siRNA showed the highest efficiency.

CONCLUSIONWe have obtained an efficient siRNA to knockdown BMP-7 expression in vitro for further investigation of the role of BMP-7 in bone and cartilage formation.

Animals ; Bone Morphogenetic Protein 7 ; genetics ; metabolism ; Cells, Cultured ; Endothelial Cells ; metabolism ; RNA, Messenger ; RNA, Small Interfering ; Rats ; Real-Time Polymerase Chain Reaction ; Transfection

BACKGROUNDDespite technical advances in tools used to facilitate implantation of cardiac resynchronization therapy (CRT) devices, there are many hurdles related mainly to the variation in the anatomy of the coronary veins. One such difficulty is the presence of a very sharply-angulated or tortuous of the lateral or posterolateral cardiac vein.

METHODSTotally 44 patients, 28 males and 16 females, with congestive heart failure and intraventricular conduction delay were studied retrospectively. There were 23 patients who had left ventricular (LV) lead implantation using standard techniques and equipment. For the other 21 patients with LV lead implantation we used the Attain Select II catheter delivery system. The patients were seen every 3 - 6 months for 12 months and the efficacy of the primary procedure, LV lead implantation time, procedure and fluoroscopy time and the complications associated with the two techniques were evaluated.

RESULTSThere were no significant differences in the age, gender, New York Heart Association (NYHA) functional class, ischemic etiology, QRS duration, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and LV dyssynchrony between the two groups. The LV lead implantation time, procedure time and fluoroscopy time were significantly shorter in the group using the Attain Select II catheter delivery system; LV lead implantation time from (51 ± 7) minutes to (40 ± 7) minutes (P < 0.001), procedure time from (143 ± 17) minutes to (124 ± 18) minutes (P = 0.001), and fluoroscopy time from (45 ± 7) minutes to (35 ± 6) minutes (P < 0.001). A successful procedure of LV lead implantation was significantly improved from 17/23 (74%) patients using the standard techniques and equipment, to 20/21 (95.3%) patients using the Attain Select II catheter delivery system (P = 0.06)

CONCLUSIONIt is feasible and safe to implant LV leads through the coronary sinus using the Attain Select II catheter delivery system.

Aged ; Cardiac Resynchronization Therapy ; methods ; Female ; Heart Failure ; therapy ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Ventricular Dysfunction, Left ; therapy

BACKGROUNDTissue Doppler imaging (TDI) has provided an objective means to quantify global and regional left ventricular (LV) and right ventricular (RV) function with improved accuracy and greater reproducibility than conventional echocardiography. This study was conducted to assess RV myocardial systolic activation by TDI in subjects with pulmonary arterial hypertension (PAH).

METHODSA total of 30 patients with PAH and 30 healthy volunteers, all comparable in age and sex, underwent standard Doppler echo and TDI. Using pulsed Doppler echocardiography combined with TDI, the following regional parameters were evaluated in three different myocardial segments (RV basal lateral wall, basal septal, and LV basal lateral) on apical 4-chamber view: systolic (Sm), early- and late-diastolic (Em and Am) peak velocities. RV myocardial systolic activation delay was defined as the difference in time to peak TDI systolic velocities between the RV basal lateral wall and basal septal. In addition, RV end-diastolic and end-systolic areas were measured to calculate RV fractional area change from the same apical 4-chamber view.

RESULTSCompared with the control group, patients with PAH showed increased RA and RV end-diastolic diameter (RA: (4.5 +/- 1.2) cm vs (3.0 +/- 0.8) cm, P < 0.05 and RV: (4.8 +/- 1.9) cm vs (3.4 +/- 0.5) cm, P < 0.05) and reduced RV fractional area change; (35 +/- 14)% vs (56 +/- 9)%, P < 0.05. These PAH patients showed lower myocardial peak velocities and a significant activation delay compared with controls (P < 0.05). Moreover, a strong correlation between RV myocardial systolic activation delay and RV fractional area change was shown in patients with pulmonary arterial hypertension (r = -0.82).

CONCLUSIONSIn PAH, RV myocardial systolic activation was markedly delayed, which was directly related to the RV fractional area change. RV myocardial systolic activation delay assessed by TDI could offer a unique approach to predict RV dysfunction.

Adolescent ; Adult ; Diastole ; Echocardiography, Doppler ; Female ; Humans ; Hypertension, Pulmonary ; physiopathology ; Male ; Middle Aged ; Systole ; Ventricular Dysfunction, Right ; etiology ; Ventricular Function, Right

OBJECTIVETo detect the expression of hypoxia-inducible factor-1alpha(HIF-1alpha) in endometriosis and explore the possible role of HIF-1alpha in the pathogenesis of endometriosis.

METHODSImmunohistochemistry was performed to examine the expression of HIF-1alpha in 20 normal endometrium, 20 ectopic endometrium and 68 eutopic endometrium specimens from 68 endometriosis patients, and the results were analyzed statistically.

RESULTSThe expression of HIF-1alpha was significantly increased in ectopic endometrium than in normal endometrium (P<0.01), and the expression did not undergo changes with the normal menstrual cycle in the three types of endometrium.

CONCLUSIONHIF-1alpha expression increases in ectopic endometrium, suggesting that HIF-1alpha plays an important role in the pathogenesis of endometriosis.

Adult ; Endometriosis ; genetics ; Endometrium ; metabolism ; Female ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Menstrual Cycle ; metabolism

OBJECTIVETo investigate the RHD zygosity of Rh(D)-positive Chinese Hans in order to study the mother-fetus Rh isoimmunization prophylaxis.

METHODSRh(D) blood group of 31 115 donors were serotyped, and the RHD zygosities were analyzed, or determined through a PCR method for 3628 donors of Rh(D)-positive individuals.

RESULTSAmong the 31 115 donors, 99 were tested Rh(D)-negative by indirect antiglobulin test (IAT) (0.318%). The d frequency was 0.056 41, D was 0.943 59, and Dd heterozygosity was 0.106 45 (10.6%). However the rate was 0.090 32 (about 9.0%) after excluding DEL (IAT-negative). For the 3628 PCR tested donors, 3383 were DD (93.2%), 245 were Dd (6.8%). After excluding nonfunctional RHD alleles, 7.4% of the donors were carrying one functional RHD. It showed that an Rh(D)-negative Chinese Han woman gives an Rh(D)-negative child at a rate of 3.7%-4.5% when her husband is Rh(D)-positive.

CONCLUSIONFetus Rh(D) genotyping may be unnecessary for Chinese Hans if invasive operation was needed for prenatal diagnosis. The Rh prophylaxis could be chosen assuming an Rh(D)-positive fetus.

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; China ; ethnology ; Female ; Humans ; Infant, Newborn ; Male ; Middle Aged ; Polymerase Chain Reaction ; Rh-Hr Blood-Group System ; blood ; genetics

A L9 (3(4)) orthogonal design table to be used to get nine combinations of extraction of three herbs of Wuji pill: Coptis chinensis, Tetradium ruticarpum and Paeonia lactiflora Pall., and nine extraction of single herbs correspondingly, altogether eighteen combinations. Quantification of five representative bioactive ingredients: berberine, palmatine, evodiamine, rutaecarpine, paeoniflorin in rat liver by ultra high liquid chromatography-tandem mass spectrometry after oral administration at 2 h time point of eighteen combinations. The result shows the bioactive ingredients have different concentrations betweem different combinations and the single herb with the same dosage significantly as well as the same dose combinations. C. chinensis with evodiamine concentration of low and high dose T. ruticarpum was positively correlated. T. ruticarpum with berberine concentration of low dose C. chinensis was negatively correlated and of meddle dose C. chinensis was correlated positively. T. ruticarpum with paeoniflorin concentration of middle dose P. lactiflora was correlated positively. P. lactiflora with palmatine concentration of middle dose C. chinensis was negatively correlated and with evodiamine and rutaecarpine concentration of middle dose T. ruticarpum was negatively correlated. These shows the three single herbs interactions resulted in the differences of each ingredients concentration in rat liver. The orthogonal analysis indicates the combination 12: 6: 6 make the maximum concentration in rat liver.
Administration, Oral ; Animals ; Biological Availability ; Biomedical Research ; methods ; Chromatography, High Pressure Liquid ; methods ; Drug Stability ; Drugs, Chinese Herbal ; administration & dosage ; pharmacokinetics ; Liver ; metabolism ; Male ; Plants, Medicinal ; chemistry ; Rats ; Rats, Sprague-Dawley ; Tandem Mass Spectrometry ; Temperature

OBJECTIVETo investigate the effect of lymphadenectomy adjacent to inferior mesenteric artery root on the prognosis of rectal cancer.

METHODSClinicopathological data of 260 cases with rectal cancer undergone radical operation were analyzed retrospectively. The patients were divided into two groups. Group D(2): the lymph nodes adjacent to mesenteric artery root were not excised (n=188). Group D(3): the lymph nodes adjacent to mesenteric artery root were excised (n=72). Prognosis of two groups was compared during the follow-up period.

RESULTSIn group D(2), the 1-, 3-, 5-year total survival rates (TS) were 97.3%, 87.2% and 77.1%, and tumor-free survival rates (TFS) were 93.1%, 83.0% and 76.8% respectively. In group D(3 ), the 1-, 3-, 5-year total survival rates (TS) were 94.4%, 79.2% and 73.6%, and tumor-free survival rates (TFS) were 86.1%, 76.4% and 71.0% respectively. The differences of TS and TFS between two groups were not significant according to Kaplan-Meier analysis (P>0.05). Multivariate analysis revealed that the excision of lymph nodes adjacent to mesenteric artery root was not statistically correlated with the recurrence, metastasis and survival time after radical operation of rectal cancer.

CONCLUSIONExcision of lymph nodes adjacent to inferior mesenteric artery root has no significant impact on prognosis and it is unnecessary in the radical operation of rectal cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymph Node Excision ; methods ; mortality ; Lymph Nodes ; surgery ; Lymphatic Metastasis ; Male ; Mesenteric Artery, Inferior ; surgery ; Middle Aged ; Prognosis ; Rectal Neoplasms ; mortality ; pathology ; surgery ; Survival Rate ; Treatment Outcome

Deoxycytidylate (dCMP) deaminase is an enzyme belonged to dCMP cyt deam family. The dCMP deaminase from Streptococcus mutans UA159 was cloned and expressed in E. coli, and purified to homogeneity. The FPLC size exclusion chromatography analysis reveals that the S. mutans dCMP deaminase forms hexamer in solution. The protein was crystallized using hanging drop vapour-diffusion method and diffracted to a resolution of 3.1 ?. The diffraction data were collected at BSRF beamline 3W1A. The crystals belong to P213 space group, with unit cell parameters a = b = c = 113.2 ?, ? = ? = ? = 90?. Assuming there are two subunits per asymmetric unit, the Matthews coefficient is 3.6 ?3?Da-1. This is the first crystallization report of the wild-type deoxycytidylate deaminase.