Objective To investigate the predictive value of epicardial adipose tissue(EAT) thickness for the recurrence of atrial fibrillation (RAF) after concomitant valve replacement and bipolar radiofrequency ablation.Methods From January 2012 to May 2014,156 patients with permanent atrial fibrillation and organic valvular diseases underwent concomitant valve replacement and successful bipolar radiofrequency ablation in the First People's Hospital of Shangqiu.After 1 year of follow-up,the recurrence of AF was analyzed and the correlation factors were analyzed statistically.Results All patients completed a regular follow-up.During a 12-month follow-up period,RAF was observed in 39 patients (25.0％).Echocardiography-derived regional EAT thickness was significantly greater in RAF patients than that in non-RAF patients((6.9±0.6) mm vs.(5.5±0.7) mm,t=4.649,P＜0.05).The EAT thickness strongly correlated with patients age,body mass index,Ratio of left atrial diameter,mitral diastolic blood flow velocity and early diastolic velocity of mitral annulus,low density lipoprotein-cholesterol and thyroglobulin (r =0.62,0.57,0.68,0.59,0.73,0.76;P ＜ 0.05).Cox multivariable analysis showed that,duration of AF history (95％CI:1.01-1.15,P =0.040),left atrial diameter (95％CI:1.07-1.24,P =0.021) and EAT thickness (95％CI:1.05-1.79,P =0.009) were independent predictors of RAF.Conclusion Echocardiography-derived regional EAT thickness combined with left atrial diameter may serve as effective parameters in identifying patients at the highest risk for RAF.

Objective To review the outcome of coronary artery bypass graft (CABG) using left internal thoracic artery grafts in the patients aged over 70 years old.Methods Two hundred and eighty-eight patients aged over 70 years old from January 2009 to January 2014 who underwent CABG were selected.All of the patients were divided into two groups on base of the graft:control group:only saphenous vein graft was used in 138 cases; observation group:the left internal thoracic artery to the left anterior descending artery was used in 150 cases,which also included total arterial grafting,facilitated by the use of the radial artery,right gastroepiploic artery was operated in 7 cases,beside these artery grafts,saphenous vein graft was used to anastomosis with other vessels.Results Operative mortality was 2.9％ (4/138) in control group and 2.0％ (3/150) in observation group,and there was no significance (P ＞ 0.05).The volume of blood drainage was larger in observation group [(796.2 ± 382.4) ml] than that in control group [(512.8 ± 387.5) ml],and there was significant difference (P ＜ 0.05).At the same time,there was no significant difference in the incidence rate of second thoractomy,malignant arrhythmia,stroke,poor wound healing,and usage of intraaortic balloon counterpulsation between two groups (P ＞ 0.05).Conclusion It does not increase the mortality and incidence of serious complications using the left internal thoracic artery to the left anterior descending artery in the patients aged over 70 years old during CABG.

ObjectiveTo investigate the risk factors in ischemic stroke following total hip replacement. MethodsThe clinical data of 18 patients who suffered ischemic stroke following total hip replacement were compared with other 142 patients without ischemic stroke following total hip replacement who were randomly selected as control. ResultsThe incidence rate of ischemic stroke following total hip replacement in our hospital was 1.8%. Age,hypertension, history of stroke,falling of systolic pressure and diastolic pressure during opereration were significantly different between patients and controls(P<0.05).There was no significantly different in sex,previous cardiac diseases, diabetes, hyperlipemia,and the bleeding in operation between patients and controls(P>0.05).ConclusionAge,hypertension, history of cerebrovascular disease,falling of systolic pressure and diastolic pressure during opereration are the important risk factors of ischemic stroke following total hip replacement.

Objective To study the predictive value of heart-type fatty acid-binding protein (H-FABP) in the improvement of survival rate in patients with severe sepsis.Methods There was a prospective case-control study in 50 patients with severe sepsis from October 2014 to October 2015.According to the international guidelines for severe sepsis and septic shock set in 2012,all patients were divided into sepsis group (n =16),severe sepsis group (n =14) and septic shock group (n =20),and these patients were further divided into to survival group (n =22) and non-survival group (n =28) as per patients surviving within 28 days.Gender,age,ethnic,and Acute Physiology and Chronic Health Evaluation score (APACHE Ⅱ) were recorded.H-FABP,B-type natriuretic peptide (BNP),creatine kinase (CK),creatine kinase isoenzyme (CK-MB),and troponin-T (cTn-T) were determined within 6 hours after admission.The statistical software SPSS21.0 was used to do t test,test,and the receiver operating characteristic curve for comparison between groups.Results H-FABP in septic shock group was higher than severe sepsis group and sepsis group (P ＜ 0.01).The 28-day mortality of septic group (80％) and severe sepsis group (71.4％) were higher than sepsis group (12.5％) (P ＜ 0.01).Non-survival' s H-FABP,BNP,cTn-T,CK,CKMB was higher than survivals (P ＜ 0.05).Through the ROC of H-FABP (AUC=0.748,P=0.003,95％ C I:0.605-0.890) and BNP (AUC =0.714,P=0.010,95％ CI:0.573-0.856),it shows that H-FABP is better than BNP.when H-FABP take 9.902 ng/mL,the sensitivity of 82.1％,specificity of 63.6％.H-FABP,BNP has a certain value in 28-day mortality prediction.Conclusions Sepsis shock has significantly higher 28-day mortality than sepsis and severe sepsis.Compared with BNP,H-FABP has greater predictive value in sepsis patients,it will increase along with the aggravation of the disease;it can also predict 28-day mortality.

Objective To compare the effects of combined epidural-spinal anesthesia and different doses ropivacaine anesthesia for the lower limb operations. Methods One hundred and thirty-six patients for elected operations and 83 emergency operation patients receiving lower limbs operations were enrolled for the comparative study. Patients receiving spinal analgesia were divided into 3 groups with 0.1%, 0.15% and 0.2% ropivacaine, respectively. The dosage was increased from 3mg to 7mg with 1mg increase stepwise for each group, and a total of 15 groups and 219 cases were studied with this regime. For the patients undergoing epidural block anesthesia, 0.2% ropivacaine was used. Patients were placed in lateral recumbent position with the affected limb on the top. Puncture was done at the level of L2-3 interspace with a fine trocar, keeping the anesthetic level at T9-10. The anesthetic effect, BP, HR, SpO2 and Bromage score were then recorded. Results The effective rate was 95% in 6mg and 7mg group, 50%-55% in 5mg group, and 30% in 4mg group. The dosage of 3mg failed to achieve anesthesia. There was no failure in 7mg groups. During the operations the BP, HR and SpO2 were stable. No nausea and vomiting occurred, except 1 patient complaining of headache and 2 patients with urine retention. The intraoperation Bromage score of the affected limbs were 2-3, and for the unaffected limbs it was 0-1. Conclusions It is suggested that 0.1-0.2% ropivacaine in a dosage of 6-7mg for spinal anesthesia combined with 0.2% ropivacaine for epidual block can be used in the limb operation. It overcomes many side effects of traditional lumbar anesthesia. This method may be of great advantage to patients with complete analgesia, less anesthetic agent used, earlier ambulation, stable circulation and respiration, and fewer side-effects.

Objective To evaluate the influence of anus-preserved procedures on life quality of patients with low rectal carcinoma.Methods One hundred and forth cases with low rectal carcinoma who underwent double stapling technique(DST) (n =64) or support binding procedure(SBP) (n =50) were selected as our subjects.Patients in both group were undergone total mesorectal excision (TME) to sever mesorectum.Anal Function was assessed by Xu Zhongfa Anal-Function's criterion after operation.All patients were performed a 5 years follow-up.Results The 5-years survival rate and local recurrence rate were 65.63％ (37/64),20.03％ (13/64) respectively in DST group,and 76.0％ (38/50),6.0％ (3/50) in SBP group.The differences were significant (P =0.049,0.032).The postoperative general occurrence rate of dysuria,dysporia and sexual disorder in the DST group were 31.25％ (20/64),17.19％ (11/64) and 45.31％ (29/64) respectively,higher than those of SBP group(14.00％ (7/50),4.00％ (2/50) and 26.00％ (13/50) ;P =0.037,0.045,0.034).Conclusion Both DST and SBP therapy are proved to be effective in terms of anus-preserved treatment for low rectal cacinoma.5-year survival rate is similar in the two groups,while the survival quality is better in SBP group than in DST group.

Objective To explore the consistency between preoperative clinical TNM stage and postoperative pathological TNM stage of gastric cancer and look for the underlying reason.Methods Sixty-four patients of gastric cancer with complete clinical data from December 2010 to December 2011 in Gansu Provincial Hospital were enrolled into this study.All cases were performed postoperative pathological TNM staging according to the TNM stage criteria of gastric cancer from JGCA(the 14th edition,2010),and the results were compared with preoperative TNM staging,then we studied the consistency of T staging,N staging and M staging using SPSS 18.0.Results The Kappa value from T staging of preoperative and postoperative was 0.729,showing a good consistency.The N stage' s consistency was lower,Kappa value being only 0.216.For M staging,Kappa value 0.743,having a good consistency.Conclusions According to the General Rules for Gastric Cancer Treatment,a accurate TNM staging and individual treatment plan can be made for gastric cancer patients in clinic.But the overestimate and underestimate still existed,especially in N staging.Therefore,making a accurate judgment for N staging according to all kinds of preoperative clinical data and images is the key to improvement of preoperative TNM staging accuracy and treatment.

This paper studied on breeding selenium-enriched yeast by protoplast mutagenesis. A strain which the content of selenium is the highest is selected from thirteen strains yeast. The optimum conditions to form protoplast are lysed by 1 g/100 mL lywallzyme for 120 min, the formation and regeneration being 95.2% and 21.8% respectively. By mutating breed a strain of A1 which the content of selenium is 821 mg/kg and the amount of dry cell of 0.84 g/100 mL is obtained.

0.05).Conclusion TP may have protective effects on chronical hypoxia induced polycythemia in rats.

Objective To explore if grape seed polyphenols (GSP) reverses human breast cancer multidrug resistance. MethodsIn this study,adriamycin-resistant human breast carcinoma cells ( MCF-7/ADR ) and its parental cells (MCF-7) were used to determine the effect of GSP. MTT assay was adopted to evaluate the cytotoxity. Western blot and Northern blot were performed to observe the expression of MDR1 in MCF-7/ADR. Adriamycin accumulation was measured by flow cytometry (FCM). ResultsGSP ( 1.2 mg/L ,2.4 mg/L) inhibited the expression of P-gp to 80.83%( t =5.58,P