Objective To summarize clinical characteristics, diagnosis and surgery of abnormally origination of left coronary artery from the pulmonary artery. Methods Clinical data of 10 patients with left coronary artery abnormally originating from pulmonary artery were analyzed, including 5 men and 5 women, aged from 13 to 40 years. Definite diagnosis was made by ultrasonic cardiogram (UCG) and cardiac catheter examination. Three cases were simply abnormal origination, six cases combined with MI, and one case combined with both MI and ventricular aneurysm of left ventricular apex. Ligation of the abnormal coronary artery was done in four patients, three were given pulmonary artery inner tunnel plasty under extrocorporeal circulation. Open implantation of left coronary artery to ascending aorta were done in 3 patients, while plasty of mitral valve were performed in 5 and ventricular aneurysm resection in 1. Results One patient died postoperatively. The follow-up ranged from 1 month to 11 years. One patient received replacement of mitral valve 16 months after first surgery due to severe MI. All the followed-up patients presented no myocardial ischemia or infarction, no residual shunt or late death. Cardiac function was rehabilitated to grade 1. Conclusion Obvious blood dynamics and cardiovascular morphology changes existed in patients with left coronary artery abnormally originating from pulmonary artery. Early diagnosis and surgery should be done. Proper surgical approach is the key to success.

[ ABSTRACT] Chemokines and their receptors have been implicated mostly in tumor progression and metastasis. Atypical chemokine receptors ( ACKRs) comprise a group of 7-transmembrane domain proteins structurally similar to G pro-tein-coupled receptors.However, ACKRs do not induce classical signaling via the typical G protein-mediated pathways. ACKRs efficiently internalize the cognate chemokine ligands and act as scavengers instead.ACJRs are composed of at least 3 members of chemokine receptors: Duffy antigen receptor for chemokines ( DARC, also known as ACKR1 ) , D6 ( also known as ACKR2) and ChemoCentryx chemokine receptor (CCX-CKR, also known as ACKR4).These receptors bind to and/or internalize their chemoattractant ligands without activating signal transduction cascades leading to cell migration.In this review, we summarize the recent progress regarding the roles of ACKRs in the progression and metastasis of tumor.

Objective To observe the influence of environment stimulation on learning and memory ability and hippocampal pathology of neonatal rats with hypoxic-ischemic brain damage (HIBD).Methods The models of HIBD SD rats were established by the method of Rice, and were divided randomly into three groups: enriched environment stimulation group (EE), impoverished environment stimulation group (IE), and standard environment stimulation group (SE). The sham-operation rats were served as control group. Different environment stimulation was administrated to the rats since day 1 after HIBD.On the day 28,Morris water maze was used to evaluate the learning and memory ability. HE staining and nissl stain were employed to observe the pathological change and the number of neurons in hippocampus of rats.Results The learning and memory ability of EE group was significantly higher than that of SE group (P0.05), and the ability of SE group was higher than that of IE group ( P0.05). The number of SE group was lower than that of Sham group (P

Although the surgical techniques has already improved in heart transplantation, heart preservation is still the biggest obstacle to the surgery.At present, heart preservation effective time is only 4-6 hour.How to extent the time of heart preservation is a major research direction.Comparison of available preservations for heart transplantation based on its mechanism and the prospect of its Clinical application.

Objective To summarize the experience of radical treatment of tetralogy of fallot in adults.Method Between Nov. 1985 and May 2005,115 patients over 18 years of age with tetralogy of fallot underwent total surgical correction.Longitudinal or oblique right ventriculotomy was used to ensure complete release right ventricular outflow obstruction and complete ventricular septal defect closure.Transannular patches were used in 74 patients,right ventricular outflow tract(RVOT) patches in 37 cases,primary closure of right ventricle in 5 cases,respectively.One patient had separate pulmonary main artery and RVOT enlargement.Results Seven patients had residual septal defect and 3 cases suffered from residual RVOT obstruction.Severe cardiac output syndrome occurred in 10 patients and 6 patients died early postoperatively with the mortality rate of 5.22%.Conclusion By careful surgical management,the treatment of total correction in adult patients may result in good effectiveness.

Objective To compare the surgical outcome and long-term follow-up after mitral valve replacement through either minimally invasive(MI) or traditional median stemotomy(ST) surgery.Methods All 1 096 patients who received either MI or ST mitral valve replacement surgery,between January 1,2012 and July 30,2015 were analyzed for outcome differences due to surgical approach using propensity score matching(MI group n =405,ST group n =691).Find out the best matched with the 202 cases of the two groups.The clinical data of patients were collected including operativedata,postoperativecomplications,and follow-up.Results MI Group was longer in CPB time [(145.97 ±34.65)min vs.(92.24 ±25.58)min,(P ＜ 0.001)],aortic clamping time [(93.89 ± 25.25) min vs.(56.42 ± 18.09) min,(P ＜ 0.001)],and operating time[(237.49 ± 47.48) min vs.(217.31 ± 55.95) min,(P ＜ 0.001)].The MI group was associated with more less in transfusion(24.26％ vs 33.66％ P=0.037),mechanical ventilation[(15.29 ±11.45)h vs.(21.34 ±40.36)h,(P=0.041)],ICU stay[(44.12 ±39.51)h vs.(61.15 ± 106.01) h,(P =0.033)],volume of thoracic drainag[(404.11 ±485.84)ml vs.(674.82 ±585.37)ml,(P＜0.001)],postoperative drainage time[(2.59 ±1.75)d vs.(4.25 ±1.91)d,(P ＜0.001)],hospital stay [(5.64 ± 3.07) d vs.(1 1.44 ± 6.71) d,(P ＜ 0.001)].There were no significant difference in the complications of follow-up(P ＞ 0.05).SF-36 score had no significant difference either(P ＞ 0.05).Conclusion The minimally invasive thoracoseopic has longer in CBP time and cross-clamp time,;but it didnot increase the risk of mortality and complications.What's more,havingless trauma,fewer transfusions,lcss wound infection,faster rccovcry,and high satisfaction with the incision in long-term follow up and other advantages.Minimally invasive thoracoscopic cardiac surgery is safe,effective and feasible.

OBJECTIVEIn this study, we aimed to investigate the expressions of adhesion molecules on human bronchial epithelial cells and neutrophils in co-culture system, assess the effects of puerarin on suppressing these adhesion molecules expressions, and explore the roles of two crucial signal-transduction elements p38 mitogen-activated protein kinase (p38 MAPK) and nuclear factor kappa B (NF-κB) in modulating adhesion molecules expressions.

METHODSNeutrophils and BEAS-2B cells (one human bronchial epithelial cell line) were co-cultured, and adhesion molecules expressions on cell surface were detected using flow cytometry. The mRNA levels of adhesion molecules were assessed by real-time quantitative polymerase chain reaction (real-time qPCR). Phosphorylated p38 MAPK and inhibitor κB were analyzed by Western blot.

RESULTSIn co-culture system, adhesion molecules expressions on BEAS-2B cells and neutrophils were enhanced significantly (P<0.05). Correspondingly, the mRNA levels of adhesion molecules were also increased greatly. Moreover, the pretreatment of peurarin obviously suppressed adhesion molecules expressions on cell surface. Furthermore, phosphorylated p38 MAPK and inhibitor κB in BEAS-2B cells and neutrophils were elevated in co-culture system, but decreased significantly after upon the treatment of peurarin (P<0.05).

CONCLUSIONSCoculture boosted the interactions between human bronchial epithelial cells and neutrophils mimicking airway inflflammation, whereas peurarin decreased the expression of adhesion molecules on cell surface by suppressing the activities of p38 MAPK and NF-κB pathways, and exhibiting its anti-inflflammation activity.

Animals ; Base Sequence ; Bronchi ; cytology ; enzymology ; metabolism ; Cattle ; Cell Adhesion Molecules ; metabolism ; Cell Line ; Coculture Techniques ; DNA Primers ; Down-Regulation ; drug effects ; Epithelial Cells ; enzymology ; metabolism ; Isoflavones ; pharmacology ; NF-kappa B ; metabolism ; Neutrophils ; enzymology ; metabolism ; Phosphorylation ; Real-Time Polymerase Chain Reaction ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVETo summarize the clinical characteristics, surgical management and postoperative complications in patients with congenital bicuspid aortic valve (CBAV) over 50 years of age.

METHODSFrom January 2009 to September 2011, 73 CBAV patients aged 51-76 years (mean 61.8∓0.73 years) were treated in our center. Except for 1 patient who underwent Bentall surgery and another having Wheat surgery, all the patients received aortic valve replacement (AVR), including 7 with double (mitral and aortic) valve replacement (DVR), 6 with mitral valvular plasty, 11 with tricuspid valvular plasty, 8 with coronary artery bypass graft implantation, 1 with aortic-left ventricular tunnel repair, 1 with atrial maze ablation, and 1 with left atrial thrombosis removal.

RESULTSTwo patients died after the surgery, with a perioperative mortality rate of 2.7%. The cardiopulmonary bypass time was 78-217 min (mean 131.9 ∓6.0 min) with an aortic blocking time of 56-158 min (mean 88.2 ∓4.8 min) and total postoperative ICU time of 23.0-647.4 h (mean 97.9∓10.5 h). The postoperative complications included low heart output syndrome in 5 cases, bleeding in 4 cases, wound debridement in 4 cases, and hemodialysis due to acute renal failure in 1 case. The left ventricular end diastolic diameter reduced significantly after the surgery (52.6∓1.7 vs 43.2∓1.0, P=0.001). No significant changes were detected in the left ventricular ejection fraction (62.3∓2.5 vs 65.5∓1.3, P=0.257).

CONCLUSIONThorough preoperative examination, preoperative risk factor assessment, timely perioperative interventions, careful evaluation of patients' tolerance of surgery, and prevention of surgical complications are essential to decrease the perioperative mortality in elderly patients with CBAV.

Aged ; Aortic Valve ; abnormalities ; surgery ; Coronary Artery Bypass ; Female ; Heart Valve Diseases ; mortality ; surgery ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Postoperative Complications ; prevention & control ; Retrospective Studies

OBJECTIVETo investigate the influencing factors for the time of umbilical cord separation in full-term newborns.

METHODSThe time of umbilical cord separation was recorded in 337 full-term newborns. Single factor and multifactor unconditioned logistic regression were performed to investigate the influencing factors of umbilical cord separation. Fourteen possible factors associated with the time of umbilical cord separation, including sex, gestational age, body weight, position of umbilical cord ligature, length of umbilical cord stump, umbilical cord diameter, cleanness of umbilical cord paster, hand cleanness of medical staff and family members and umbilical infection, were involved.

RESULTSThe single factor correlative analysis demonstrated that the position of umbilical cord ligature, length of umbilical cord stump, umbilical cord diameter, cleanness of umbilical cord paster, and umbilical infection were influencing factors for the time of umbilical cord separation (P<0.05). The multifactor unconditioned logistic regression analysis demonstrated four major influencing factors for umbilical cord separation: position of umbilical cord ligature, length of umbilical cord stump, cleanness of umbilical cord paster, and umbilical infection.

CONCLUSIONSThe following factors contribute to early separation of umbilical cord: the proper position of umbilical cord ligature (<0.5 cm to umbilical ring), the umbilical cord stump of <0.5 cm, keeping the umbilical cord paster clean and the prevention of umbilical infection.

Bacterial Infections ; prevention & control ; Female ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Time Factors ; Umbilical Cord ; microbiology

Objective To compare the effects of clopidogrel with or without combined with CYP3A4-metabolized statin in treating coronary artery disease (CAD) among the elderly patients.Methods The study cohort was defined as all patients were over 60 years of age and hospitalized for CAD who were prescribed clopidogrel between January 2000 and February 201 1.A total of 1021 patients were enrolled,with 178 of them prescribed clopidogrel and 843 patients were administrated clopidogrel combined with statins (CYP3A4-metabolized statins 636 and non CYP3A4-metabolized statins 207).The primary endpoint was all cause of death and the second endpoint were non-fatal myocardial infarction (MI),but hospitalized for unstable angina,stroke,transient ischemic attack,or repeated revascularization (PCI or coronary artery bypass graft).Results Among the clopidogrel group and the clopidogrel plus statins group,the incidence density of death was 6.86/1000 and 3.18/ 1000 respectively,with crude RR as 2.15(95％CI:1.39-3.33) and statistically significant (x2=3.53,P＜0.01).The incidence density of composite thromboembolic events did not show statistical significance (P＞0.05).The two groups were 1∶1 matched,after propensity score matching,clopidogrel coadministrated with statins group showed significant decrease in all cause of death,with RR as 0.42 (95％ CI:0.19-0.93),x2=7.23,P＜0.01.No significant difference was observed in deaths or composite thromboembolic events between statins via different cytochrome P450 pathways.Conclusion Clopidogrel with statin could reduce the mortality of elderly CAD patients compared with clopidogrcl without statin.The result did not show statistical significance between CYP3A4-metabolized statins or non CYP3A4-metabolized statins regarding the mortality or composite endpoint events.