OBJECTIVE:To probe into the situation and safety of drug use in surgical patients of our hospital and new prob-lems resulted from ppatients controlled analgesia(PCA). METHODS:Medication and the safety of drug used for PCA in 291 surgical patients of orthopedic department and general surgery department of our hospital in 2009 were analyzed. RESULTS:90 catego-ries of drugs were involved and utilization frequency was 2 627 with each person of 9.03. 70.45% of patients received PCA after operation. There were statistical significance in difference of applying anesthetic agents,analgesics and other drugs in different departments(P

There are more than 200 regulatory subunits of protein phosphatase 1(PP1), among which phosphatase 1 nuclear targeting subunits(PNUTS) are involved in the dephosphorylation process of PP1, regulate the activity and subcellular localization of PP1, and can also regulate the cell cycle process and centrosome maturation and division by binding to specific regulatory proteins. PNUTS can regulate the functions of many proteins related to tumorigenesis, for example, bind to oncogene MYC to regulate its transcription function, and bind to tumor suppressor phosphatase and tensin homolog(PTEN) to inhibit its negative regulation on PI3K-AKT signaling pathway. In addition, PNUTS are also related to the cell apoptosis mediated by Caspase protein family. In this paper, the structure of PNUTS and the role in tumorigenesis are reviewed in order to provide a reference for finding new targets for tumor treatment.

There are more than 200 regulatory subunits of protein phosphatase 1(PP1), among which phosphatase 1 nuclear targeting subunits(PNUTS) are involved in the dephosphorylation process of PP1, regulate the activity and subcellular localization of PP1, and can also regulate the cell cycle process and centrosome maturation and division by binding to specific regulatory proteins. PNUTS can regulate the functions of many proteins related to tumorigenesis, for example, bind to oncogene MYC to regulate its transcription function, and bind to tumor suppressor phosphatase and tensin homolog(PTEN) to inhibit its negative regulation on PI3K-AKT signaling pathway. In addition, PNUTS are also related to the cell apoptosis mediated by Caspase protein family. In this paper, the structure of PNUTS and the role in tumorigenesis are reviewed in order to provide a reference for finding new targets for tumor treatment.

Objective To explore the improving safety measures of colon interposition after esophagectomy .Methods From January 2003 to December 2014, 65 cases of colon interposition after esophagectomy were performed, and some improve-ments were made in the methods and procedures .Mainly including: Preoperative evaluation to first operation; Selection of co-lon segment; Simplify vascular anatomy;Cervical anastomosis was replaced by intrathoracic anastomosis;Modified anastomosis sequence; Strengthen preoperative preparation.Results There were no perioperative deaths.Only 2 patients with cervical fis-tula, due to malnutrition automatically discharged.The rate of anastomotic leakage on neck were 27.77%(10/36) and 6.89%(2/29) in the chest.2 cases were completed intestinal obstruction after jejunostomy , 1 cases of volvulus and 1 cases of intus-susception confirmed by reoperation.Conclusion Colon interposition after esophagectomy is a very important way of surgery. The operation process is complex, but as long as mastering the point of surgery, improving the surgical procedures, the good effect can be obtained and greatly improve the safety of the operation .

Objective To review the experience of treatment for prosthetic valve endocarditis(PVE)after mitral valve replacement(MVR)in 16 cases.Methods From September 1979 to December 2010,16 patients were diagnosed as PVE after MVR by modified Duke University diagnostic criteria.There were 10 males and 6 females.Their ages ranged from 19 to 55 years old(mean 28 years old).The incidence of PVE was 0.97％(16/1657)after MVR.Blood culture positive was in 5 cases.Medical treatment alone was performed in 10 patients who were treated by using Penicillin or Vancomycin with other broad-spectrum antibiotics,using Fluconazole and Amphotericin if necessary.Combined medical and surgical management were performed in 6 cases.One emergency case was operated because of obstinate heart failure.Five cases underwent operation after adequate antibiotics treatment and general condition improvement.The infective tissue and vegetation were aggressively debrided after the infective prosthetic valve removed.Before the new valve was replaced paravalvular tissue must be flushed with diluted iodine solution and large quantities of normal saline.Tricuspid valve repair (TVR)was performed during the same period in 3 cases.Results Hospital death occurred in 8 patients and only 2 patients were recovery in group with medical treatment only.The main reasons of death were infective shock and cardiac failure in 4 patients,cerebral complications(embolism or bleeding)and multiple organs failure in 4 cases.While 6 patients cured after combined medical and surgical management.Follow-up had been carried out in 8 cases for 1.7 to 15 years(mean 5.1 years).Eight years later one patient was re-operated because of severe tricuspid regurgitation and paravalvular leak.There was no PVE recurrence in others.Conclusion Combined medical and surgical management for PVE get a better result than medical treatment alone.Good prognosis lies in timely diagnosis,adequate antibiotics,aggressive debridement of infective tissue and better myocardium protection during operation.

10.3969/j.issn.1007-3969.2013.05.010

Objectives: To clone genes associated with spermatogenesis. Methods: Usingmodified mRNA differential display technique,we analyzed the differences of geneexpression among four different age mice groups(1-week,2-week,3-week,4-week oldmouse respectively). A gene highly expressed in 1-week old mouse was cloned andsequenced. Results: Sequences comparison showed that the gene shared high homologywith LTBP-3 gene. Conclusions: The results indicated that LTBP-3 gene might becorrelated with spermatogenesis. Natl J Androl,2001,7(2):84～86

Objective To retrospectively analyse the clinical data of off-pump coronary artery bypass grafting surgery(OPCAB)in our department and summarize the clinical experience of peri-operative management.Methods From January 2007 to May 2008,253 patients underwent OPCAB.Seventy-six cases with left main disease(including 18 cases of single left main lesion and 58 cases of complex lesion);13 cases had single vessel disease;32 cases had double vessels disease and 190 cases had triple vessels disease.Eighteen cases received emergency OPCAB.All vessel anastomosis were performed with coronary artery stablizer and shunt through median sternotomy.Resuits Three cases died after operation(1.2%).Intra-aortic balloon pump was used in 11 cases.Mechanical ventilation time was 3-168 h[(24.1±22.3)h],and ICU stay time was 1-14 day[(2.8±2.0)d].Postoperative hospital stay time was 8-42 days[(15.6±6.3)d].Conclusion OPCAB is reliable for most bypass cases.With appropilate peri-operative management,a satisfied result will be acceptable.

Objective To summarize the clinical experiences of 1386 patients undergoing off-pump coronary artery bypass grafting(OPCAB)during Jan 2002 to Mar 2008.Methods OPCAB was done through midsternumtomy under ordinary-temperature anesthesia after radial artery,left breast artery and vena saphena magna were taken.Patients over 70 years old accounted for 32.35%,and the oldest was 99 years old.Emergency and subemergency OPCAB was done in 111 cases,re-do CABG with off-pump technique was done in 52 patients.Results 24 cases died during perioperation,with mortality of 1.73%and all other patients discharged from the hospital.Following operation,the symptoms of angina pectoris were relieved and the life quality was much beaer than that before operation.Conclusion OPCAB is feasible for older patients,who are complicated with other chronic diseases for elder patients.Skillful technique of surgeon,right indications for OPCAB and management of peri-and postoperation are key to success of operation.