Objective To examine the hemodynamic changes and oxygen metabolism during off-pump coronary artery bypass grafting (OPCABG) .Methods Twenty patients (18 male, 2 female) aged (60?8)yr, weighing (71?9)kg undergoing OPCABG were studied. The patients were premedicated with diazepam 10 mg PO 2h before operation and morphine 10 mg and scopolamine 0.3 mg im 30 min before operation. Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1, fentanyl 5-10 ug?kg-1 and vecuronium 0.12-0.15 mg?kg-1 and maintained with 0.5%-2% isoflurane inhalation, fentanyl 10-20 ug?kg-1 and intermittent iv boluses of vecuronium and in some patients propofol infusion. Radial artery was cannulated. Swan-Ganz catheter was placed via internal jugular vein into pulmonary artery. Hemodynamic parameters including MAP, HR, cardiac index (CI), stroke volume (SV), MPAP, PCWP, SVR, left ventricle stroke work index (LVSWI) and RVSWI; oxygen metabolism including oxygen delivery (DO2) , oxygen consumption (VO2) and oxygen extraction ratio (ERO2); regional cerebral oxygen saturation (rSCO2) and arterial blood lactate level (ABL) were measured and recorded before skin incision (A), when pericardium was incised before operation on the heart (B), during operation on the heart (C), 10 min after operation on the heart (D) and at the end of surgery (E) . Results During surgical manipulation on the heart (C) MAP, SV and CI decreased while CVP and HR increased, but the decrease in CI and SV was not significant. During manipulation on the heart(C) DO2 decreased whereas ERO2 increased, but there was no significant change in VO2. After manipulation on the heart (D) DO2 and ERO2 returned to the pre-manipulation level. Arterial blood lactate concentration increased at E. Conclusion OPCABG can be performed uneventfully under our general anesthetic regimen. During operation while the beating heart is being manipulated MAP tends to decrease while CVP and HR increase. The changes are of short duration and do not result in any serious consequeaces.

BACKGROUND:Tai Chi exercise can relax the affected muscle of patients, increase muscle flexibility and strength, promote normal movement patterns of stroke patients, inhibit abnormal posture and spasm patterns, improve patient motion control and balance function. OBJECTIVE:To systematicaly assess the effectiveness of Tai Chi on the movement, emotional disorder and quality of life in patients with stroke. METHODS: Al extracted data from databases of PubMed, EMbase, Web of Science, EBSCO, Google Scholar, CNKI, VIP and Wangfang were obtained, which were the randomized controled trials addressing the effects of Tai Chi on the movement, emotional disorder and quality of life in patients with stroke. The retrieval time was from database establishment to July 1st, 2015. According to the inclusion and exclusion criteria, two reviewers independently screened, extracted data and assessed the methodological quality of the included literatures. Then the meta-analysis was conducted using RevMan 5.3 software. RESULTS AND CONCLUSION:A total of 15 randomized controled trials involving 1016 patients were included. The results of Meta-analysis suggested that: Tai Chi was superior to the conventional rehabilitation in improvement of balance function [mean difference (MD)=7.87, 95% confidence interval (CI) (4.56, 11.18),P < 0.000 01], gait speed [MD=0.27, 95%CI (0.04, 3.94),P=0.02], anxiety [standardized mean difference (SMD)=-0.47, 95%CI(-0.89,-0.04),P=0.03] and quality of life [SMD=0.65, 95%CI(0.10, 1.19),P=0.02], and there were statistical differences. But there was no statisticaly significant difference in the improvement of depression and functional walking ability. These findings indicate that Tai Chi is superior to the conventional rehabilitation in the improvement of balance function, gait speed, anxiety and quality of life. However, large-sample, high-quality randomized controled trials are needed to provide more reliable evidence for the effect of Tai Chi in depression and functional walking ability.

Objective To explore the incidence and distribution features of neonatal phenylketonuria(PKU) and congenital hypothyroidism(CH) in Lianyungang area.Methods The heel blood samples dried on filter paper was collected from newborns after 72 hours.As the screening indicators,PKU was detected through serum phenylalanine concentration(Phe) detection by Guthrie′s bacterial inhibition assay and CH was detected through serum thyroid stimulating hormone(TSH) levels detection by time-resolved fluorometry(TRFIA) or enzyme linked immunosorbent assay(ELISA).Results Sixty-four children with CH were diagnosed and the rate of CH was 1∶2423,41 patients were examined by thyroid gland nuclein kinescope picture,among which there were 23 patients whose thyroid glands were unusal.These patients lived in 45 towns(streets),which had no difference between men and women,city and country side.A couple of twins were screened for CH;15 cases of PKU was detected with an incidence of 1∶10 339.These patients′ parents were neither consanguineous marriage nor dominance hereditary family history.Their physical and mental development were similar to the same age children after interventive treatment.Conclusions The distribution of CH and PKU is diffuse in Lianyungang.Neonatal screening is the only valid means to find patients with CH and PKU.

Objective To investigate the expression of osteopontin(OPN) mRNA in breast tissues containing microcalcifications and the significance of OPN in tumor pathogenesis and metastasis of breast cancer.Methods The expression of OPNmRNA in 128 samples of tissues of breast lesions and adjacent breast tissues and 9 samples of metastatic lymph nodes were examined.Results The expression of OPNmRNA was highest in(calcified) foci of breast cancer tissues and in metastatic lynph nodes,lower in calcified foci of benign breast tissues and lowest in breast tissues adjacent to breast cancer and in benign tissues without calcification.The differences between the defferent tissues were significant(all P

AIM: To investigate the effectiveness of minimally invasive conjunctivorhinostomy for complete bicanalicular obstruction, and to evaluate the advantages, complications, and degree of satisfaction after this technique.
●METHODS: Twenty - two patients ( 22 eyes ) with complete bicanalicular obstruction were selected as the research subjects, all patients were treated by minimally invasive conjunctivorhinostomy. The post - operation follow- up lasted for 3 - 27mo. Medical records were reviewed for demographic data, surgical time, length of the tubes, duration of follow-up, patency of the tube, postoperative complications, whether satisfied or dissatisfied with this procedure. Meanwhile, the data was analyzed for evaluating the clinical efficacy of minimally invasive conjunctivorhinostomy.
●RESULTS: The overall operative success rate was 95%(21/22), and the overall patient satisfaction was 68% (15/22 ) . The post - operation complications included:granulation tissue proliferation of the lower end of the tube 2 cases (9%), middle turbinate blocked the opening of tube 3 cases ( 14%) , nasal mucosa covering the opening of tube 1 case ( 5%) , the tube was blocked by secreta 5 cases ( 23%) , foreign body sensation 10 cases (45%), dry eye 2 cases ( 9%), regurgitation of nasal secreta discharge 8 cases (36%).
●CONCLUSION: Minimally invasive conjunctivorhinostomy can treat the complete bicanalicular obstruction. This operation method is characterized by simplicity, high success rate, short operative time, less tissue trauma, less complications, without facial scarring, and it is worth clinical promotion.

Objective To explore the relationship between serum cccDNA and liver damage in the patients with chronic HBV infection.Methods Serum cccDNA,ALT of 156 patients with chronic HBV infection were measured,and pathology of liver tissue in 85 patients was detected.Results The positive rate of Serum cccDNA and ALT had no significant difference(P＞0.05).Between pathology light,medium and severe group,S0_(～1) and S_(2～4) group,G_(0～1) and G_(2～4) group the serum cccDNA mean was significantly different(P＜0.01).The positive rate of serum cccDNA was significantly different between the group of NAASC and ASC,CH,LC,HCC,and the group of ALT ≤40u/Land 40～80,80～400,≥400u/L(P＜0.01).Conclusion Serum cccDNA and liver inflammation,fibrosis and ALT had no relevance,serum cccDNA with at a low level may be non-active,but should be excluded from serious liver diseases.

Objective To explore the effect of aerobic exercise training on artery elasticity among patients with essential hypertension.Methods A total of 155 cases of patients with essential hypertension (EH)were selected,and were divided into control group(76 cases)and aerobic exercise group(79 cases).Control group was follow routine drug therapy,and aerobic exercise group was follow aerobic exercise training besides the routine therapy for 12 weeks.CAVI,ABI values,limb blood pressure,TG,TC,LDL -C,HDL -C and U -MA were compared before and after the intervention.Results After the intervention,bilateral CAVI values of aerobic exercise group were 7.76 ±0.15,7.88 ±0.15,8.87 ±0.25 and 8.89 ± 0.22,and lower than those before the intervention(P <0.05).The decline range of bilateral CAVI value(the difference between the mean differences before and after the intervention)were 1.03 ±0.07 and 1.03 ±0.06,significantly wider than the control group of 0.33 ±1.97 and 0.15 ±0.08(P <0.05).After the intervention,limb systolic pressure,diastolic blood pressure and triglyceride,cholesterol decreased in the aerobic exercise group(P <0.05).The limb systolic blood pressure and left limb diastolic blood pressure decreased in the control group after intervention (P <0.05),but the decline range was smaller than the aerobic exercise group(P <0.05 ).Conclusion The aerobic exercise training could significantly improve arterial elasticity among patients with essential hypertension.

Objective To investigate the function of transferrin-DNA complex,transported by transferrin(Tf)and trans-arterial injection via interventional approach be the duel-target-orientated delivery and the transferring into malignant cells to get more effective therapy.Methods p53-LipofectAMINE ligand with different concentrations of Tf(0,10,25,50,100?g)transfected the 4 strains including LM6、Hep3B、YY and L02 in vitro to evaluate the gene transfeetion efficiency through western blot.Then,after setting up the VX2 hepatocarcinoma models,we delivered the Tf-p53-LipofeetAMINE complex into the hepatic arteries via interventional techniques to analyse the transfection efficiency in vivo.Results Tf,within the range of 10 100?g,could increase gene transfection efficiency mediated by liposome,and the efficiency increases with the raise of Tf concentration.Combination with interventional technique to inject Tf-DNA complex into tumor arteries,gene transfeetion efficiency was enhanced in rabbit models.Conclusion Tf can enhance gene- liposome transfection efficiency,furthermore with combination of interventional catheter technique,there would be a potential duel-target-orientated gene therapy method.(J Intervent Radiol,2007,16:99-103)

AIM: To investigate the antitumor activity and mechanism of Paecilomyces tenuipes polysaccharide(PTPS).METHODS: PTPS-I was obtained by water extraction and alcohol precipitation,and purified by DEAE-cellulose and Sephadex G-100 chromatography.Human erythroleukemia cell line K562,laryngocarcinoma cell line Hep2 and hepatic carcinoma cell line SMMC-7721were co-cultured with PTPS-I or the conditioned medium which prepared with PTPS-I-stimulated human mononuclear cells(PTPS-I-MNC-CM),and the proliferation of tumor cells was determined.The cell counting kit-8(CCK-8) was used to determine the proliferation of MNCs.The FQ-RT-PCR was applied to investigate the expression of TNF-? and IL-6 mRNA in MNCs.RESULTS: PTPS-I-MNC-CM inhibited the proliferation of K562,Hep2 and SMMC-7721 cells in vitro(P

Objective:To study the expression and regulation of TLR2/4 in mycobacterium tuberculosis heat shock proteins 16. 3 (mycobacterium tuberculosis heat shock proteins 16. 3,MTB Hsp16. 3) effect on mouse bone marrow-derived macrophages in vitro. Methods:Bone marrow cells were isolated from tibia and femurs of BALB/c mice and incubated with GM-CSF,then detected the expression of CD11b and F4/80 with flow cytometry and observed morphology. The M0 macrophages were stimulated with MTB Hsp16. 3 for 0 h,12 h,24 h,36 h,48 h and 72 h. Real-time PCR detected the expression of TLR2/4 in intracellular at different time point. Silencing macrophages cell surface TLR2/4 molecules by siRNA technology which stimulated with MTB Hsp16. 3 for 0 h,12 h,24 h,36 h,48 h and 72 h. Real-time PCR detected the expression of TLR2/4,Ym-1,Fizz1,IL-10,TNF-α,iNOS and TGF-βin intracellular at different time point. Results:Morphology analysis showed that MTB Hsp16. 3 stimulated macrophages were round cells stretching out pseudopodia,whereas MTB Hsp16. 3 stimulated silencing TLR2/4 macrophages had elongated fibroblastoid. Real time PCR detected the expression of TLR2/4 were upregulated after MTB Hsp16. 3 stimulated M0 macrophages. MTB Hsp16. 3 stimulated silencing TLR2/4 macrophages the expression of IL-6, TNF-α, iNOS were upregulated, whereas IL-10, TGF-β, Ym-1 and Fizz1 were downregulated. Conclusion:MTB Hsp16. 3 may stimulated M0 macrophages to M2 macrophages and suppress M1 macrophages through binding with TLR2/4 receptor,which may be involved the progresss of MTB evaded macrophage phagocytosis.