Objective To explore the value of endoscopic mini-incision greater saphenous vein harvesting for coronary artery bypass operation. Methods A total of 411 patients scheduled for coronary artery bypass operation were given either endoscopic vein harvesting(EVH Group,n=136) or open vein harvesting(OVH Group,n=275),based on patient's willingness.The operation outcomes and incision complications were compared between the two groups. Results The incidence of various incision complications was significantly lower in the EVH Group(18.4%,25/136) than in the OVH Group(36.7%,101/275)(?~2=14.406,P=0.000).As compared with the OVH Group,the EVH Group had lower incidences of edema(1.5% vs 35.3%;?~2=56.861,P=0.000),paraesthesia(7.4% vs 33.8%;?~2=33.937,P=0.000),hematoma(16.2% vs 27.3%;?~2=6.214,P=0.013),and incisional liquefaction(0.7% vs 8.7%;?~2=10.174,P=0.001) of the lower extemity.The total operation time were 226.3?28.5 min in the EVH Group and 224.7?19.2 min in the OVH Group,without significant difference between the two groups(t=0.673,P=0.502).Early graft failure happened in 1 case in each of the groups,without significant difference between the two groups(?~2=0.000,P=1.000).The numbers of distal coronary anastomoses were 3.6?0.8 in the EVH Group and 3.3?1.0 in the OVH Group,with significant difference(t=3.049,P=0.002). Conclusions Endoscopic greater saphenous vein harvesting can significantly reduce the morbidity associated with incision complications,whereas does not prolong the operative time,increase the incidence of early graft failure,and decrease the number of distal coronary anastomoses.

Objective To understand the functional status and radiation protection requirements of helical tomotherapy (TOMO) unit when it is applied in clinic treatment so as to promote the construction of TOMO quality control system.Methods A helical tomotherapy unit with a type of tomotherapy Hi-Art was employed as the radiotherapy unit.A series of tests and analyses on dosimetric and radiation safety performance parameters of the TOMO unit were conducted with the use of a A1SL ionization chamber,a set of solid water equivalent phantoms and other test equipments.The performance parameters were compared with that of a conventional 6 MV accelerator with a type of ARTISTE.Results The deviations of static and dynamic output dose were-1.51％ and 1.18％,respectively.The values of PDD10/PDD1.5 and PDD20/PDD1.5 were 0.608 and 0.318 within the range of X-ray quality parameters calibration.Under the different field conditions of 40 cm × 5 cm,40 cm × 2.5 cm and 40 cm × 1 cm,the stability of transverse/longitudinal dose distribution curve was no more than 1.20％ and the offset distance of Jaw width was smaller than 0.5 mm.Radiation leakage ratio of the treatment rotating center from the muhileaf collimator (MLC) was 0.20％.No matter the average or the maximum value of the leakage radiation from couch plane was less than 0.02％.Conclusions The performances and testing requirements of TOMO unit are different from a conventional electron linear accelerator,the quality control index of TOMO unit should be set seperately and tested strictly in terms of the specific requirements of the unit by complying with the QC programme.The reliable quality control system should be established and effectively implemented to serve the radiotherapy quality and radiation safety effectively in the tomotherapy.

ObjectiveDiabetes is an independent risk factor for coronary artery bypasss grafting(CABG). Off pump coronary artery bypasss (OPCAB) experience in 251 cases was reviewed to determine whether diabetes wou ld be applicable in OPCAB procedures.MethodsConsecutive 251 patients underwent OPCAB over 12 month period. This study included 71 diebetic patients (DM group) and 180 nondiabetic patients (NDM group). Preoperative v ariables were compared between the two groups by univariate analysis.R esultsNo differences were found regarding the length of stay in cardio intensive care unit [DM group(2.4?0.3)d; NDM group (2.4?0.3) d;P=0. 386], and sternal complication (DM group: 5.7%;NDM group: 3.9%;P=0.511) . In hospital complications were as follows: death rate(DM group: 2.8%; NDM gr oup: 1.1%; P=0.680); stroke (DM group: 2 8%; NDM group: 1 7%; P=0 623 ); hemofiltratioin renal failure (DM group: 2.8%; NDM group: 0.5%; P=0.194); myocardial infarction(DM group: 0%; NDM group: 0.5%;P=1.000); blood using were more frequent in DM group comparied with NDM group (P=0.111). ConclusionOPCAB in diabetic patients is as safe as in non diabetic patients.

Background Curcumin can eliminate free radical arising in the system and superoxide anion and further inhibit lipid peroxidation.Researches proved that curcumin has resisting effect on oxidative damage of lens,but its effect on the formation of age-related cataract is under clear.Objective This study was to investigate the effect of curcumin on the cataract induced by sodium selenite.Methods Thirty healthy clean SD rats of 12-day-old were selected.All the rats were randomly divided into the normal control group,model group and curcumin group and ten rats for every group.The selenite cataract models were established in the rats of model group and curcumin group by the injection of sodium selenite subcutaneously.Meanwhile,0.005 ％ curcumin lavaged the rats in the curcumin group daily for two weeks.Lens of the rats were examined under the slit lamp at 4,7,10,14 days after injection in all groups,and the opacification of lens was graded based on the He' criteria.The lenses of rats were obtained at the end of experiment and then the level of superoxide dismutase (SOD),the activities of malondialdehyde (MDA) and glutathione peroxidase(GSH-Px) in rat lens were detected using biochemical assay method.The use of experimental animals followed the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The lenses were transparent throughout the experimental duration in the blank control group.Compared with model group,the development of the Ⅲ,Ⅳ,Ⅴ grade of cataract was slow down in the curcumin group with the significant difference( P＜0.05 ).The content of MDA,SOD and GSH-Px activity in lens appeared considerable differences among 3 groups ( MDA:F =215.42,P＜0.01 ; SOD:F =46.83,P＜ 0.01 ; GSH-Px:F=44.29,P＜0.01 ).The level of SOD was significantly reduced in the model group and the curcumin group compered with blank control group ( P ＜ 0.05 ) and that in the curcumin group was higher than the model group ( P＜0.05 ).The MDA level in the model group and the curcumin group was obviously rised in comparison with blank control group( P＜0.05 ),but that in the curcumin group lowed in comparison to model group( P＜0.05 ).GSH-Px activity in the curcumin group was significantly lower than that in blank control group and higher than that in the model group( P ＜ 0.05 ).Conclusions The curcumin can effectively delay rather than the cataract formation induced by sodium selenite in SD rat by improved the resistance of oxidation in the lens.

Objective To assess the level of radiation exposures of operators in three typical types of interventional fluoroscopic procedures.Methods Alderson Radiation Therapy (ART) phantom was used to stimulate the practices of diagnosis and therapy using TLDs for dose measurement.The radiation exposures of eye lens, neck, and breast were measured when the lead shielding of machine was on/off and the equivalent dose and effective dose to the eye lens were estimated.Results Radiation exposure of head was obviously reduced by 85% -90% when the lead shielding was on.The doses in different procedures were different.In cerebral angiography the dose equivalent of eye len was the highest in the three procedures.The annual effective dose for the operators was smaller in peripheral vascular interventions than that in cardiovascular interventional therapy and that in cerebral angiography.Conclusions The operators involved in intervention will receive an annual effective dose of less than 20 mSv as recommended by the ICRP under the protection conditions provided by the current study, except for eye lens.Attention should be paid to the protection of the eyes of operators.

Objective To study the radiation dose level and dose distribution of leakage and scattering radiation in a helical tomotherapy (TOMO) room,and to identify the dose distribution characteristic which is different from the conventional radiotherapy so as to provide scientific data for the radiation protection of TOMO.Methods A helical tomotherapy facility typed Tomotherapy Hi-Art was employed as the radiotherapy device.The air kerma from leakage radiation and scattering radiation distributed on the couch plane and in TOMO room were detected mainly by GR-200A TLDs of LiF(Mg,Cu,P),while 100 Gy were being accumulated under the condition of simulation radiation treatment.Then,the leakage radiation ratio and scattering-leakage radiation ratio (the ratio of site radiation dose to isocenter standard output dose) were calculated.Results The radiation level and dose distribution of leakage radiation and scattering radiation in the TOMO treatment room were in bilateral symmetry to the rotation isocenter and the treatment couch longitudinal axis,and the radiation level in front of the radiotherapy device was significantly higher than that of the rear of the TOMO equipment.In the plane of treatment couch,the maximum leakage radiation ratio at the position 100 cm away from the isocenter was only 1.3 × 10-4,and the mean value of the leakage radiation ratio at the position 300 cm away from the isocenter was lower than 2.0 × 10-5.The scattering radiation at 200-300 cm away from the isocenter was accounted for 25％-30％ of the leakage radiation from the responding sites,and the indoor scattering radiation decreased faster than leakage radiation with the distance from the isocenter.Conclusions The radiation level of leakage and scattering in a TOMO room is significantly lower than that in a conventional radiotherapy room.

Objective To investigate the effects of different doses of alcohol on the synthesis of testosterone and the expression of androgen binding protein(ABP)mRNA in rat testis.Methods Forty male Wistar rats were randomly divided into 4 groups(10 rats each group)and received either distilled water(control group)or alcohol(alcohol-fed groups)for 5 months.Alcohol was administered by garage with a single daily dose : 5 g/kg(large dose group),2.5 g/kg(middle dose group)and 0.5 g/kg(small dose group).Testosterone content was measured by ELISA.mRNA levels of peripheral-type benzodiazepine receptors(PBR),PPARct and ABP were assayed by RT-PCR.Results Compared with control group:(1)ethanol feeding with daily doses of 5 g/kg,2.5 g/kg and 0.5 g/kg significantly decreased testosterone levels by 31.13%(P0.05)respectively,indicating that ethanol might impair testosterone synthesis;(2) mRNA levels of PBR were decreased in all three ethanol-treated groups(all P

Objective To discuss the effects of prophylactic chemotherapy on the outcomes and prognosis of invasive mole patients.Methods One hundred and fifteen invasive mole (IM) patients older than 40 years were registered in Peking Union Medical Collage Hospital.Eleven of them were treated with prophylactic chemotherapy before diagnosed as IM prophylactic chemotherapy group,while the other 104 cases received therapeutic chemotherapy after diagnosed as IM (non-prophylactic chemotherapy group).The general clinical data (including age,clinical stage,risk factor score),treatment,outcomes and relapse of patients were retrospectively compared between two groups.Results (1) The age of prophylactic chemotherapy group and non-prophylactic chemotherapy group were (47±5) versus (46±4) years old.Ratio of clinical stage Ⅰ-Ⅱ were 3/11 versus 29.8％ (31/104),clinical stage Ⅲ-Ⅳ were 8/11 versus 70.2％ (73/104).Ratio of risk factor score 0-6 were 11/11 versus 84.6％ (88/104),risk factor score ＞6 were 0 versus 15.4％(16/104).There were no significant statistical differences between two groups in age,clinical stage or risk factor score (all P＞0.05).(2) Treatment:the total chemotherapy courses between prophylactic chemotherapy group and non-prophylactic chemotherapy group (median 7 versus 5) were significantly different (Z=3.071,P=0.002).There were no significant statistical differences between two groups in the chemotherapy courses until negative conversion of β-hCG,consolidation chemotherapy courses,total therapeutic chemotherapy courses or ratio of hysterectomy (all P＞0.05).(3) Outcomes and relapse:between the prophylactic chemotherapy group and the non-prophylactic chemotherapy group,the complete remission rate were 11/11 versus 98.1％(102/104),the relapse rate were 0 versus 1.0％(1/102).There were no significant difference between the two groups in outcomes or relapse rate (P＞0.05).Conclusions Prophylactic chemotherapy does not substantially benefit the IM patients older than 40 years.Prophylactic chemotherapy may not significantly improve patients' prognosis,in which increased sample size is required in further study.

Aim To investigate the effect of dihydro-myricetin (DMY) on the insulin resistance in 3T3-L1 adipocytes and its mechanism. Methods The differ-entiated adipocytes were treated with 1 μmol · L-1 dexamethasone ( dex ) for 7 days to induce insulin re-sistance. With or without insulin, DMY (1 × 10 -6 ~ 1 × 10 -8 mol·L-1 ) was exposed to the normal and in-sulin-resistant 3 T3-L1 adipocytes for 48 hour and 72 hour, respectively. Rosiglitazone ( 1 × 10 -6 mol · L-1 ) was used as a positive control. The glucose up-take was evaluated by glucose consumption. The mR-NA expressions of glucose transporter 4 ( GLUT4 ) , protein kinase B ( PKB/Akt) and adiponectin were de-termined by RT-PCR analysis. Results DMY ( 5 × 10 -7 ~ 1 × 10 -8 mol·L-1 ) concentration-dependently increased the glucose uptake in insulin-resistant 3 T3-L1 adipocytes, similar to rosiglitazone. However, DMY did not affect the glucose consumption in normal 3T3-L1 cells. After treatment of DMY to insulin-resist-ant 3T3-L1 adipocytes for 72 hours, the expressions of GLUT4 , Akt2 and adiponectin mRNA were markedly increased, compared with the dexamethasone-treated group. Conclusion DMY could improve the insulin resistance in 3T3-L1 adipocytes, which is related to in-creasing the mRNA expression of GLUT4 , Akt2 and adiponectin.

OBJECTIVETo observe the effect of TCM therapy, by principle for nourishing Qi, activating blood circulation and resolving phlegm, on quality of life of patients with chronic obstructive pulmonary disease (COPD).

METHODSSeventy-two COPD patients with Qi-deficiency, blood stasis and phlegm retention syndrome were randomly divided into two groups. Thirty-five patients in the treated group were treated with the integrative traditional and Western medicine, that is, conventional Western medicine combined with Chinese compound recipe prescribed based on the principle of nourishing Qi, activating blood circulation and resolving phlegm, or with Feikang granule and Bailing capsule, while 37 in the control group was treated with conventional Western medicine alone. The clinical efficacy was evaluated by assessment software of COPD quality of life after patients were treated for 3 months.

RESULTSThe clinical efficacy in the treated group was superior to that in the control group, showing significant difference (P < 0.01).

CONCLUSIONCompound recipe prescribed according to the therapeutic principle for nourishing Qi, activating blood circulation and resolving phlegm can improve the symptoms of patients with COPD at stable stage, elevate their quality of life.

Adolescent ; Adult ; Aged ; Bronchodilator Agents ; therapeutic use ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; Quality of Life