Objective To systematically review the myocardial protective effect of ischemic preconditioning in patients undergoing open heart surgery.Methods PubMed,EMBASE,Highwire,CENTREN and its affiliated clinical trial registration data center,CBM and CNKI were searched to identify all randomized controlled trials involving the myocardial protective effect of ischemic preconditioning in patients undergoing open heart surgery under general anesthesia.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included the incidences of postoperative cardiac death,myocardial infarction and ventricular arrhythmias and postoperative inotropic drug requirement.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software.Results Twelve randomized controlled trials (8 high-quality trials and 4 medium-quality trials) involving 626 patients were included in our Meta-analysis.Meta-analysis indicated that ischemic proconditioning significantly reduced the incidence of postoperative ventricular arrhythmias and postoperative inotropic drug requirement (P ＜ 0.05) and had no effect on the incidences of postoperative cardiac death and myocardial infarction (P ＞ 0.05).Conclusion Ischemic preconditioning can reduce the postoperative ventricular arrhythmias and have no effect on postoperative cardiac death and myocardial infarction in patients undergoing open heart surgery.

BACKGROUND:Synthetic patch as an important substitute to pelvic tissue can replace damaged pelvic fascia tissue, and has been widely used in the pelvic floor reconstruction. OBJECTIVE:To observe the efficacy and complications of pelvic floor reconstruction with mesh, and to explore its safety and effectiveness. METHODS: Forty-five pelvic organ prolapse female patients were divided into two groups according to patient’s wilingness: experimental group, pelvic floor reconstruction with mesh (n=25); control group, transvaginal hysterectomy combined with vaginal wal repair (n=20). Perioperative conditions were recorded, and uterine prolapse staging, complications, pelvic floor function, pelvic discomfort, as wel as an objective cure rate were evaluated in the two groups during the folow-up. RESULTS AND CONCLUSION:Compared with the control group, the experimental group was characterized as shorter operative time, less amount of bleeding, milder infections, and faster recovery (AlP < 0.05). At 6 months of folow-up, the score on uterine prolapse staging was higher in the experimental group than the control group; at 12 months, the scores on pelvic floor function and pelvic discomfort as wel as the incidence of complications were significantly lower in the experimental group (P < 0.05), but the objective cure rate was higher compared with the control group (P < 0.05). These findings suggest that pelvic floor reconstruction with mesh for pelvic organ prolapsed can reduce the operative time and blood loss and promote postoperative recovery. Meanwhile, it can significantly improve pelvic floor function, pelvic discomfort, postoperative complications, the rate of exposure, and the objective cure rate, which is safe and effective during the short-term folow-up.

Objective To evaluate the clinical value of MR spectroscopy in intracranial neoplasm. Methods 52 cases with brain neoplasm or recurrent neoplasm or non-tumor lesion confirmed by pathology were undergone proton MRS before stereotactic biopsy, or operation. Results Of 52 cases, 38 were neoplasm and 14 were nonneoplastic lesion, 34 of 38 brain tumor, 11 of 14 nonneoplastic lesion were diagnosed correctly. The characteristics on MRS of glioma were remarkable Cho increase and NAA decrease, Lac in the tumors and the central necrotic area was elevated. Metastasis: Cho increased,NAA disappeared or obviously decreased and Lac increased, but the peritumoral region was normal. Lymphoma: Cho increased, NAA decreased moderately, Lip presented, but the peritumoral region was normal. Demyelination lesion: slight or median decreased NAA and normal Cr, Lac increased slightly. All metabolism decreased or disappeared in radiation necrosis, Cho was relative high compared with NAA. Brain abscess: Lac increased in the centre of abscess and perilesion was normal.Conclusion MRS has significant value in detecting and differentiating brain lesions.

Objective To describe the characteristic MR findings in the brain in patients with amyotrophic lateral sclerosis (ALS), and to assess the diagnostic value of conventional MR imaging and fractional anisotropy (FA) of diffusion tensor imaging (DTI). Methods Conventional MR imaging was performed in 14 clinically proved ALS patients and 12 age-matched normal controls. Contrast enhanced MR images were acquired in 2 patients. Axial and coronal DTI scans were performed in 10 patients and 12 normal controls with SE-EPI sequence. The b value was 1 000 s/mm 2, the number of diffusion sensitive gradient direction was 25. For quantitative assessment of the corticospinal tract (CST), FA value of bilateral CST was measured at the level of posterior limb (PL) of the internal capsule (IC) and the cerebral peduncle of the midbrain, respectively, and statistical analysis was performed. Results Focal slight low signal intensity on T 1WI and high signal intensity (hyperintense to gray matter) on T 2WI was demonstrated in 6 ALS cases (42.9%) in bilateral PL of the IC, and the high signal was longitudinally continuous from the PL to the cerebral peduncle on T 2WI coronal plane, corresponding to the course of CST. In another 8 ALS cases (57.1%), the focal slight low signal intensity on T 1WI and slight high signal intensity (isointense to gray matter) on T 2WI was revealed in bilateral PL of the IC. No abnormal contrast enhancement was detected in the 2 cases. In control group, the focal slight low signal intensity on T 1WI and slight high signal intensity (isointense to gray matter) on T 2WI was demonstrated in all 12 subjects in bilateral PL of the IC. FA values of the patient group were significantly lower than that of the control group at the level of the PL of the IC (F=7.38, P

Objective To investigate T cell receptor(TCR)variable β(BV)chain usage at the maternal-fetal interface and explore the relationship between the skewed TCR BV usage and unexplained recurrent spontaneous abortion(BSA).Methods Eighteen cases with unexplained RSA,together with matched 41 women with normal pregnancies in first trimester from Renji Hospital,Shanghai Jiao Tong University were studied.A high-resolution spectrum typing analysis of complementarity-determining region 3 (CDR3)was used to detect and compare the degree and frequency of TCR BV family expression in deciduas between RSA patients and normal controls.Results(1)The expression degree of BV19(0.029±0.031 vs.0.013±0.010,P=0.038)in RSA group showed a higher usage,while BV5.2(0.040±0.035 vs.0.067±0.052,P=0.046)showed a significantly lower usage when compared with normal controls.No significant difference in the expression of the other TCR BV families between RSA and controls were observed(P>0.05).(2),TCR BV2,3,6,and 7 were the four most common BV families in deciduas of patients with RSA and normal controls,whose frequencies were all mors than 50%.In RSA group,higher frequencies of BV15 (33.3%vs.7.3%,P=0.018),BV19(38.9%vs.14.6%,P=0.049)and BV20(33.3%vs.7.3%,P=0.018)were observed;meanuhile lower frequencies of BV4(33.3%vs.65.9%,P=0.026)and BV7 (66.7%vs.92.7%.P=0.018)distributions were observed.The other TCR BV families did not display significantly different freqencies of distribution(P>0.05).Conclusions It is suggested that a significant skewed TCR BV family occurs at the maternal-fetal interface in patients who undergo abortion.The specific skewed usages of TCR BV might be associated with the susceptibility to unexplained pregnancy loss.

Objective To investigate the pathologic foundation,clinical characteristics and CT features of microscopic polyangiitis(MPA)with lung involvement.Methods Clinical data of 6 patients of MPA with lung involvement in 2003-2006 were retrospectively analyzed.Results The types of lung imaging manifestations as the followings:(1)Mutiple flaky shadow in both lung in 3 cases.(2)Ground-glass shadow in 1 case.(3)Disseminated interstitial lung involvement in 2 cases.The main respiratory symptom was haemoptysis except cough and expectoration.Renal damaging often occurred besides the lung.Six cases with positive antineutrophil cytoplasmic antibody(ANCA)and 5 cases with positive P-ANCA/MPO-ANCA were found in laboratory examination.Conclusions The CT manifestations of MPA with lung involvement have no characteristic features.Clinical characteristics and laboratory examination can help to understand and diagnose MPA with lung involvement early.

Objective To investigate the value of prothrombotic state (PTS) in prediction of perioperative cardiac events in elderly patients with coronary heart disease undergoing noncardiac surgery.Methods One-hundred and twenty-eight ASA physical status Ⅰ or Ⅱ elderly patients (NYHA class Ⅰ or Ⅱ) of both sexes,aged 6575 yr,undergoing elective abdominal surgery,were enrolled in the study.Total intravenous anesthesia was performed during surgery.Venous blood samples were collected for detection of the levels of D-dimer,thrombus precursor protein and P-selectin (molecular markers of PTS).Detection of PTS was based on the three indexes mentioned above.The patients were divided into 2 groups according to the cardiac events occurred during surgery and within 3 days after surgery:non-cardiac event group and cardiac event group.The general data of patients and each index during surgery were recorded.Logistic regression analysis was used to pick out the potential risk factors for cardiac events.Results Twenty-nine patients developed cardiac events.There was no significant difference in age,obesity,ratio of diabetes,duration of operation,and ratio of PTS between non-cardiac event and cardiac event groups (P ＜ 0.05 or 0.01).Logistic regression analysis showed that old age,diabetes,prolonged duration of operation,and PTS were independent risk factors for cardiac events (P ＜ 0.01).Conclusion PTS produces some value in prediction of perioperative cardiac events in elderly patients with coronary heart disease undergoing noncardiac surgery.

With the deepening of modernization of traditional Chinese medicine (TCM), the method of quantification and standardization of TCM (i.e., quantitative characterization of TCM) has been more and more widely accepted by researchers. Chemometrics processes complicated data of TCM through applied mathematics, statistics and com-puter technology. And multivariable study was introduced into the quantitative characterization of TCM with great achievements. This article reviewed existed problems of quantitative characterization in TCM, the principles, char-acteristics, limitations, commonly used statistical methods and application conditions on quantitative characteriza-tion of TCM. With this review, a reference for further study of quantitative characterization of TCM was provided and a further research idea of combination with main methods of chemometrics was given.

Objective To supervise military training by application of clinical classification of fatigue fracture so as to decrease the occurrence and development of fatigue fracture. Methods From Feb.1999 to Feb.2002, the knowledge of clinical classification of fatigue fracture was applied in the military training in which it was essential to prevent and treat fatigue fracture. Results From 1999 to 2002, the incidence of fatigue fracture decreased year by year. Types Ⅱand Ⅲof fatigue fracture decreased significantly. Conclusion Clinical classification plays an important role in decreasing the occurrence and development of fatigue fracture.

Objective To explore the TCM pathogenesis regularity of nonalcoholic fatty liver disease (NAFLD);To provide basis for clinical syndrome differentiation and treatment. Methods A cross-sectional study was used. The clinical observation form of NAFLD was used to collect the patient data. Factor analysis and singular value decomposition methods were used to study the internal factors of the four diagnostic characteristics. The differences between the various analytical methods were compared. Results Factor analysis used the α factor analysis method, the principal component method, and the image factor method. The results of α-factor analysis were the best. The first three factors had the highest explanatory rates of data, namely spleen-dampness factor, kidney deficiency factor and qi deficiency factor, which constituted the basic pathogenesis factor of NAFLD. The singular value decomposition method obtained 3 singular values, namely spleen and kidney qi deficiency, liver and kidney yin deficiency, and qi and yin deficiency, also highlighted the spleen and kidney deficiency in the pathogenesis of NAFLD. Conclusion Spleen-kidney deficiency plays an important role in the pathogenesis of NAFLD. Treatment based on deficiency for nonalcoholic fatty liver disease has great clinical significance.