Objective To analyze the feasibility and superiority of off-pump coronary artery bypass grafting(OPCAB) in patients with left main coronary lesions.Methods A retrospective study was carried out to review our experience on 392 cases with left main coronary lesions,who underwent CABG in our hospital.Among the cases,279 patients(71.2%) underwent OPCAB and 113 cases received CCABG.The early postoperative mortality and complications of the two groups were compared.Results The number of bypass grafts was(4.17?0.86) in Group OPCAB and(4.24?0.94) in Group CCABG,showing no significant difference between them(t=-0.710,P=0.478).No significant difference was detected in peri-and post-operative morbidity between the two groups [atrial fibrillation: 31(11.1%) vs 8(7.1%),?2=1.459,P=0.227;perioperative myocardial infarction: 7(2.5%) vs 3(2.7%),?2=0.000,P=1.000;renal inefficiency: 9(3.2%) vs 4(3.5%),?2=0.000,P=1.000;pulmonary complications: 15(5.4%) vs 6(5.3%),?2=0.000,P=1.000].The early postoperative mortality of Group OPCAB was significantly lower than that in Group CCABG[2(0.7%) vs 5(4.4%),?2=4.368,P=0.037].The time of intubation[20(8-48) h vs 51(14-130) h,Z=-2.823,P= 0.005],ICU-stay [51(38-141) h vs 92(42-352) h,Z=-2.618,P=0.009],volume of transfusion [500(200-1200) ml vs 800(400-2100) ml,Z=-2.411,P= 0.016],re-open [5(1.8%) vs 10(8.8%),?2=9.052,P=0.003] and complication of CNS [3(1.1%) vs 9(8.0%),?2=10.647,P=0.001] of Group OPCAB were significantly less than that of Group CCABG.Conclusions It is feasible,safe and effective to perform OPCAB in patients with left main coronary lesions.

55 mm or course of AF over 2 years [54.5%(24/44) and 68.7%(46/67),?2=29.265,P=0.000 and ?2=13.814,P=0.000].Conclusion RFA Maze Ⅲ procedure during open-heart surgery is safe and effective for patients with AF.

Objective The preservation of all subvalvular apparatus for chronic mitral regurgitation has been reported in many studies. In this paper we analyzed the effects of complete chordal preservation for mitral stenosis versus mitral regurgitation on postoperative recovery.Methods Thirty-nine patients undergoing mitral valve replacement(MVR) with preservation of all subvalvular apparatus were divided into two groups, mitral stenosis (MS) group(n=23) and mitral incompetence (MI) group(n=16), according to the preoperative diagnosis. Echocardiography was performed preoperatively and at the time of discharge to determined left ventricular end diastole dimension (LVEDD),ejection fraction(EF) and the hemodynamics of the prosthesis.Results The LVEDD and EF did not change in MS group, declined in MI group postoperatively. No hemodynamic disorder of the prosthesis was detected in either group.Conclusions The valve replacement with preservation of all subvalvular apparatus could be used in both the mitral stenosis and mitral regurgitation.The early-term effects of two groups are similar,and the long-term effects are still to be observed.

According to the training objectives of higher vocational education of pharmacy and the requirements of employment knowledge and capability, the curriculum system can be divided into modular curriculum systems which correspond with the job posts. Additionally, a set of simulating practical curriculum systems with distinct characteristics should be established in line with the job posts. By means of the reform of curriculum systems and the overall optimizing of teaching contents, the overlapping and duplication in the existing curricula can be reduced and the teaching effects can be improved.

BACKGROUND:Inflammation plays an important role in vessel proliferation after balloon injury.Reducing inflammatory reaction may lighten the ocurrence and development of the restenosis after angioplasty.Studies have demonstrated that PPAR? excitomotor has inhibitory effects on inflammation development.OBJECTIVE:To observe the changes in inflammatory factors after carotid artery balloon injury in rats and the intervention of PPAR? excitomotor rosiglitazone.DESIGN,TIME AND SETTING:The randomized,controlled animal experiment was performed at the Central Laboratory of Shenzhen People's Hospital from January to June 2009.MATERIALS:Male SPF SD rats weighing about 350 g were selected to generate models of carotid balloon injury.METHODS:SD rats were equally and randomly divided into 3 groups:the control group,the balloon injury group and the rosiglitazone group.The left common carotid arteries were injured by balloon in the balloon injury group and the rosiglitazone group.The control group received sham operation.The rosiglitazone group was administered rosiglitazone daily by gavage,which began 4 days before operation and continued until harvesting.Accordingly,the control group and the balloon injury group were administered normal saline daily by gavage.MAIN OUTCOME MEASURES:All rats were executed under anesthesia at 14 days after operation,respectively to harvest left common carotid artery samples.The vessels were stained by hematoxylin-eosin,and Neointimal area(NIA) and media area(MA) as well as NIA/MA were calculated.Real time RT-PCR and Western Blot method were used to assay the expression of interleukin(IL)-6,IL-10,IL-17A mRNA and the distribution of nuclear factor(NF)-?B protein.RESULTS:Of the 36 rats,5 were excluded due to failed modeling or death,and 31 rats were included in final analysis.①The expression levels of IL-6 and IL-17A mRNA in the rosiglitazone group were significantly lower than the balloon injury group,but higher than the control group(P

Nitric oxide (NO) is an intra- and intercellular messenger with a broad spectrum of activities in the central nervous system, cardiovascular and immune systems. Mitochondrial nitric oxide synthase(mtNOS), which might be a new form of NOS in mitochondria, has been discovered to be active in the regulation of mitochondrial respiration, energy metabolism and many pathophysiological processes. In this review, the location, properties, physiological and pathophysiological significance of mtNOS were summarized.

OBJECTIVE: To investigate the surgery management of glottic carcinoma with high-frequency electrotome. METHOD: Twenty cases of patients with glottic carcinoma were treated by cordectomy under micro-laryngoscopy with high-frequency electrotome. RESULT: The 20 patients were followed up from 5 months to 6 years, retained good laryngeal function and structure: 1 case had local recurrences after 6 months, underwent total laryngectomy, and now no recurrence had been found: 19 cases (mild adhesions of vocal cords formed in 2 cases) had no local recurrence nor lymph node metastasis. CONCLUSION It is unnecessary to invest in expensive equipment in the cordectomy under micro-laryngoscopy with high frequency electrotome under general anesthesia and the result is satisfactory.
Aged ; Electrosurgery ; instrumentation ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; instrumentation ; methods ; Male ; Microsurgery ; Middle Aged ; Treatment Outcome

BACKGROUND: Inflammation plays an important role in vessel proliferation after balloon injury. Reducing inflammatory reaction may lighten the ocurrence and development of the restenosis after angioplasty. Studies have demonstrated that PPAR_Y excitomotor has inhibitory effects on inflammation development. OBJECTIVE: To observe the changes in inflammatory factors after carotid artery balloon injury in rats and the intervention of PPARy excitomotor rosiglitazone. DESIGN, TIME AND SETTING: The randomized, controlled animal experiment was performed at the Central Laboratory of Shenzhen People's Hospital from January to June 2009. MATERIALS: Male SPF SD rats weighing about 350 g were selected to generate models of carotid balloon injury. METHODS: SD rats were equally and randomly divided into 3 groups: the control group, the balloon injury group and the rosiglitazone group. The left common carotid arteries were injured by balloon in the balloon injury group and the rosiglitazone group. The control group received sham operation. The rosiglitazone group was administered rosiglitazone daily by gavage,which began 4 days before operation and continued until harvesting.Accordingly,the control group and the balloon injury group were administered normal saline daily by gavage. MAIN OUTCOME MEASURES: All rats were executed under anesthesia at 14 days after operation, respectively to harvest left common carotid artery samples. The vessels were stained by hematoxylin-eosin, and Neointimal area (NIA) and media area (MA) as well as NIA/MA were calculated. Real time RT-PCR and Western Blot method were used to assay the expression of interleukin (IL)-6, IL-10, IL-17A mRNA and the distribution of nuclear factor (NF)-kB protein. expression levels of IL-6 and IL-17A mRNA in the rosiglitazone group were significantly lower than the balloon injury group, but higher than the Control group( P < 0.05), The expression levels of IL-10 mRNA in the rosiglitazone group were higher than the the rosiglitazone group was down-regulated, and lower than the balloon injury group, but higher than control group (P < 0.05). CONCLUSION: Rosiglitazone can regulate the expression of II-6 IL-10 IL-17A mRNA and the balance of inflammatory factors via NF-kB,inhibit the inflammatory reaction of injured vessels and may contribute to lighten the restenosis of injured vessels.

Abstract］　AIM and METHODS:The recent work from our laboratory showed that ventral septal area (VSA) played a negative-regulatory central role in thermoregulation during endogenous pyrogen-induced fever. In order to further investigate the role of VSA in the antipyretic mechanism, we observed the effects of electrical stimulation of VSA on firing characteristics of thermosensitive neurons in preoptic anterior hypothalamus (POAH) by using extracellular microelectrode technique on 32 New Zealand white rabbits treated with interleukin-1 β (IL-1β) intracerebroventriculary (ICV). RESULTS:(1)Injection of IL-1β decreased discharging rate of warm-sensitive neurons in POAH. Electrical stimulation of VSA remarkably decreased thermosensitive coefficient of warm-sensitive neurons. (2)Injection of IL-1β caused increase in discharging rate of cold-sensitive neurons in POAH. Electrical stimulation of VSA remarkably increased thermosensitive coefficient of cold-sensitive neurons. CONCLUSTION:VSA may have an antipyretic effect through affecting the firing characteristics of thermosensitive neurons in POAH during IL-1β-induced fever.

Objective To evaluate the clinical characteristics,diagnosis and surgical repair methods of double aortic arch (DAA) associated with complex cardiac anomalies.Methods Retrospectively analyzed the clinical data of the 5 DAA associated with complex cardiac anomalies patients,4 males and 1 female,age from 41 days to 19 years old,weight 4.3-56.0 kg.Accompanied cardiac malformites including 2 cases with TOF,2 cases with DORV,and 1 case with d-TGA.4 cases were diagnosed DAA via MSCT and were surgical treated combined with cardiac malformations at same stage.1 case of DAA associated with d-TGA experienced stubborn pulmonary infection with increased airway resistance and could not tolerate ventilator weaning after aterial switch operation.Then he was diagnosed DAA with left arch atresia through MSCT.So,the patient underwent another surgery to excise the left aortic arch.Results One case worsened postoperatively by the cause of vomiting and aspiration and then died.The other four were survival and discharged with no DAA repair relating complication.Conclusion Double aortic arch can be cured by surgical repair and DAA with cardiac defects can be operated in one stage via median sternotomy.Congenital vascular ring should be considered in patients with stubborn and unexplained respiratory symptoms,who should receive timely imaging examinations for accurate diagnosis and surgical treatment at the early stage.