Objective: To compare the early and long-term outcomes between on-pump and off-pump coronary artery bypass grafting (CABG) in elder female patients.
Methods: A total of 763 female patients elder than 65 years of age received isolated CABG in our hospital from 1999-01 to 2008-12 were retrospectively studied. The patients were divided into 2 groups according to operational method: On-pump group,n=331 and Off-pump group,n=432. The mortality at 30 days post-operation, in-hospital clinical indexes and long term mortality with MACCE as all cause death, myocardial infarction (MI), stroke and repeated revascularization were compared between 2 groups.
Results: Compared with On-pump group, the patients in Off-pump group had the elder age (P<0.01), with the higher rate of cerebral vascular accident (P=0.023); less family history of coronary artery disease (P=0.012), angina (P<0.001) and emergent operation (P=0.015), less venous distal anastomoses (P<0.001) ; while higher incomplete revascularization (P<0.001). Logistic regression model comparison indicated that Off-pump group had the lower mortality at 30 days post-operation (P=0.038), less application of blood products (P<0.001), lower rate of >24h mechanical ventilation (P<0.001), less renal failure (P=0.022), pulmonary complications (P<0.001) and re-exploration for bleeding (P=0.021). The morbidity of all post-operative complications were similar between 2 groups (P=0.110). Cox regression model comparison showed that long-term all cause mortality (P=0.477) and occurrence of MACCE (P=0.265) were similar between the two groups.
Conclusion: Off-pump CABG would reduce the mortality at 30 days post-operation, have less application of blood products, shorter post-operative mechanical ventilation, less early post-operative renal failure, pulmonary complications and re-exploration for bleeding. While it could not reduce the long-term mortality and MACCE occurrence.

Objectve To optimize the synthesis process of phacolysin 1 for industrial production.Methods Phacolysin as the target product was synthesized with a total yield of 40.7% by condensation reaction of O-phenylenediamine and sulfonation reaction.The yield reported in literature was 24.8%.Results Such factors as the ratio of the raw materials,the catalyst,and the reaction time were inveatigated and optimized to make the reaction conditions mild and easy to control with less side effect.Conclusion The structure is confirmed by 1HNMR and MS,and the optimized process is more suitable for industrial production.

OBJECTIVE To investigate the positive rate of ?-lactamase,oprD2,aminoglycosides modifying enzyme and qacE△1 gene among clinical isolated strains of multi-resistant Pseudomonas aeruginosa in our hospital.METHODS P.aeruginosa was determined by VITEK,and MIC was determined by agar dilution method.TEM,IMP,VIM,oprD2,aac(3)-Ⅱ,aac(6′)-Ⅰ,aac(6″)-Ⅱ,ant(3″)-Ⅰ,ant(2″)Ⅰ and qacE△1 in strains were detected by polymerase chain reaction(PCR).RESULTS The positive rate of TEM,aac(3)Ⅱ,aac(6′)-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰ in multi-resistant P.aeruginosa were 51.4%,48.6%,40.0%,54.3%,45.7% and 60.0%,respectively.No IMP and VIM genes were detected.CONCLUSIONS Positive rate of ?-lactamase, aminoglycosides modifying enzyme is high in 35 tested strains,and that should be paid more attention.

Objective To study the clinical value of Na+/I-symporter(NIS)expression on thyroid carcinoma diagnosis and 131I therapeutic effects prediction.Methods Thirty-one cases of thyroid carcinomas enrolled in this hospital from 1998 to 2006 were included.Using immunohistochemical method,NIS expression location,positive cell staining and expression intensity were observed,which was calculated by immunohistochemical scores(IHS)and NIS expression level was compared between primary and metastatic carcinoma.Results NIS was over-expressed on the basolateral membrane in positive control——Grave disease tissue,and showed no staining in negative control.NIS was expressed in cytoplasm in all 31 primary carcinomas,and IHS was over or equaled to 4 in 80.65% of them.Except for 2 no staining,NIS was expressed in cytoplasm in the rest 28 metastatic carcinomas.NIS expression was related to the pathological type of thyroid carcinoma,the strongest in PTC,then FTC,and the weakest in fvPTC.NIS expression in metastatic carcinoma was related to that in primary carcinoma.Conclusion NIS is over-expressed in cytoplasm in most thyroid carcinoma,and the iodide uptaking defect is mainly due to its wrong location.It has great potential to be applied in clinic by that it can help with the differential diagnosis of benign and malignant thyroid diseases,especially between FTA and FTC,and that it can help predict the therapeutic effects of 131I therapy following thyroid operation.

Animals ; Eye Diseases ; parasitology ; surgery ; Humans ; Middle Aged ; Sparganosis ; diagnosis ; surgery ; Sparganum

Objective To investigate the interventional effect of multidimensional strategy to reduce the incidence of neonatal ventilator-associated pneumonia.Methods The patients who were admitted to the NICU department and received mechanical ventilation (MV) for more than 48 hours from October 2012 to September 2014 were recruited. The control group received the experienced interventions from October 2012 to September 2013, neonates from October 2013 to September 2014 were recruited as the intervention group receiving multidimensional controlling strategy, including bundle care, education, pro-cess and outcome surveillance and feedback on the practices. The compliance of before-after implementation of interventions were quantitatively evaluated,and the rate of VAP was compared between the two groups.Results The compliance rate of hand hygiene and the qualiifed rate of sputum suction, oral care, drain condensation from ventilator circuit, semi-recumbent posi-tion, and preventing of stress-ulcers were increased 17.0%, 11.4%, 14.7%, 18.2%, 37.5% and 56.3% respectively after implemen-tation of multidimensional strategy, and had statistical difference (χ2=36.47-294.36,P<0.01). But the qualiifed rate of antibiotic use only was 66.1% in the post-VAP bundle phases, and showed no statistical difference before and after(P>0.05). The VAP rate was 41.7 cases per 1000 MV-days during control group and 19.7 cases per 1000 MV-days during intervention group, had statis-tical signiifcance (P<0.05). But the rate of ventilator application showed no statistical difference between two group (P>0.05). ConclusionThe multidimensional strategy can effectively prevent the incidence of VAP.

A study was made on the pharmacokinetic regularity of effective components salvianolic acid B and ferulic acid in Salviae Miltiorrhizae Radix et Rhizoma (SMRR) and Chuanxiong Rhizoma(CR) in rats, so as to discuss the compatibility mechanism of Salviae Miltiorrhizae Radix et Rhizoma and Chuanxiong Rhizoma. Rats were randomly divided into three groups and intravenously injected with 50 mg x kg(-1) salvianolic acid B for the single SMRR extracts group, 0.5 mg x kg(-1) ferulic acid for the single CR extracts group and 50 mg x kg(-1) salvianolic acid B + 0.5 mg x kg(-1) ferulic acid for the SMRR and CR combination group. The blood samples were collected at different time points and purified by liquid-liquid extraction with ethyl acetate. With chloramphenicol as internal standard (IS), UPLC was adopted to determine concentrations of salvianolic acid B and ferulic acid. The pharmacokinetic parameters of salvianolic acid B and ferulic acid were calculated with WinNonlin 6.2 software and analyzed by SPSS 19.0 statistical software. The UPLC analysis method was adopted to determine salvianolic acid B and ferulic acid in rat plasma, including linear equation, stability, repeatability, precision and recovery. The established sample processing and analysis methods were stable and reliable, with significant differences in major pharmacokinetic parameters, e.g., area under the curve (AUC), mean residence time (MRT) and terminal half-life (t(1/2)). According to the experimental results, the combined application of SMRR and CR can significantly impact the pharmacokinetic process of their effective components in rats and promote the wide distribution, shorten the action time and prolong the in vivo action time of salvianolic acid B and increase the blood drug concentration and accelerate the clearance of ferulic acid in vivo.
Animals ; Apiaceae ; chemistry ; Benzofurans ; blood ; pharmacokinetics ; Coumaric Acids ; blood ; pharmacology ; Drug Interactions ; Drugs, Chinese Herbal ; analysis ; pharmacokinetics ; Male ; Rats ; Rats, Sprague-Dawley ; Rhizome ; chemistry ; Salvia miltiorrhiza ; chemistry

Objective To investigate the effecof arthroscopiminimally invasion fothe local excision of benign bone tumo.MethodEighpatientwith benign bone tumofrom Augus2011 to Decembe2012 were treated by arthroscopimini-mally invasive operation ,including 3 caseof osteochondrom,2 caseof bone cys,1 case of non-ossifying fibromand 2 caseof osteoid osteom.The lesion location wadetermined by the preoperative imaging dat,the arthroscope and plane cuttewere placed into the lesion arethe tumowaperformed the local lesion resection undethearthroscopimonitoring ,then the plasmwaadopt-ed to treathe resected wound surface of tumo,the bone defectwere implanted by allogeneibone .ResultEighcasewere re-covered well afteoperation .No postoperative complicationwere found .The approach incision ＜3 and the wound length ＜1 .5 cm .Two casewere filled with allogeneibone .There were no recurrence ,fracture odyfunction during the average follow up peri-odof 8-12 month.The postoperative X-ray showed thathe lesion wacompletely resected and the bone defeclesion wacom-pletely filled with allogeneibone .Conclusion The resection of deep benign bone tumoundethe arthroscopimonitoring can maximize to retain the local anatomistructure .

Adenocarcinoma ; pathology ; Carcinoma ; pathology ; Carcinoma, Squamous Cell ; pathology ; Humans ; Nasopharyngeal Neoplasms ; classification ; pathology ; World Health Organization

BACKGROUNDHost immune responses against hepatitis B virus (HBV) induced by antiviral therapy play a crucial role in viral clearance. To further investigate the immune mechanisms underlying the differences between respondents and non-respondents, we analyzed myeloid dendritic cells (mDCs), plasmacytoid dendritic cells (pDCs), FoxP3(+) regulatory T cells (FoxP3(+) Treg) and programmed death 1 (PD-1) expression in CD4(+)/CD8(+) T cells in chronic hepatitis B patients undergoing pegylated interferon (PegIFN)α-2b treatment.

METHODSPatients received PegIFNα-2b for 24 or 48 weeks, with follow-up at 24 weeks. The frequencies of mDCs, pDCs, FoxP3(+) Treg, and PD-1 expression by CD4(+)/CD8(+) T cells were evaluated by flow cytometry at baseline, weeks 4 and 12, end of treatment, and follow-up (12/24 weeks).

RESULTSIn HBeAg seroconverters (respondents), the mDC relative frequency decreased at week 4 and then rebounded at week 12. The pDC relative frequency decreased consistently. In non-HBeAg seroconverters (non-respondents), both mDC and pDC frequencies decreased slightly. The FoxP3(+) Treg relative frequency decreased during treatment and remained low during follow-up in respondents, while in non-respondents it decreased slightly during therapy but rebounded after discontinuation. In patients with HBeAg < 17.55 PEI-U/ml at week 12 and < 8.52 PEI-U/ml at week 24, the FoxP3(+) Treg frequency decreased during treatment and at follow-up. In respondents, CD4(+)PD-1 and CD8(+)PD-1 levels decreased at week 4 and remained low at week 12. In non-respondents, PD-1 expression decreased at week 4 but rebounded at week 12.

CONCLUSIONSThe results indicate that the dynamic changes in DCs, FoxP3(+) Treg frequency, and PD-1 expression by CD4(+) and CD8(+) T cells exhibit different trends in HBeAg and non-HBeAg seroconversion patients. During PegIFNα-2b treatment of chronic hepatitis B patients, these changes may be of predictive value for HBeAg seroconversion. HBsAg and HBeAg levels are related to FoxP3(+) Treg frequency.

Adult ; Antiviral Agents ; therapeutic use ; CD4-Positive T-Lymphocytes ; immunology ; CD8-Positive T-Lymphocytes ; immunology ; DNA, Viral ; blood ; Female ; Forkhead Transcription Factors ; analysis ; Hepatitis B ; drug therapy ; immunology ; Hepatitis B e Antigens ; blood ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Polyethylene Glycols ; therapeutic use ; Programmed Cell Death 1 Receptor ; analysis ; Recombinant Proteins ; therapeutic use ; T-Lymphocytes ; immunology ; T-Lymphocytes, Regulatory ; immunology