Objective To compare the outcomes of off-pump versus on-pump CABG.Methods From 2002 to 2008,CABG was performed in 105 patients aged 80 years and over,including 45 without cardiopulmonary bypass (CPB) or off-pump (OP) CABG (OPCAB) and 60 with CPB (onpump CABG).The outcomes were compared between two groups.Results The mean ICU stay was (37.1±30.3) h in OPCAB group and (60.6±58.2) h in on-pump CABG group (P＜0.01).Average ventilator-assisted time was (10.8±9.7) h for OPCAB group versus (22.3±35.7) h for onpump CABG group (P＜0.01).Postoperative atrial fibrillation occurred in 31.1％ of OPCABG patients and 41.7 ％ of on-pump CABG patients (P＜0.01).The mortality rate was 5.0％ in OPCABG group versus 8.3％ in on-pump CABG group (P＜0.05).Conclusions OPCABG is a safe and efficient method of myocardial revascularization in the elderly patients with lower morbidity and complications.

BACKGROUND:The anesthesia process is required strict in establishing rabbit models of ileal neobladder. It is required for cleaning operation field, quick postoperative recovery, and the choice of anesthetics and anesthesia does not influence smooth muscle peristalsis. OBJECTIVE:To compare the anesthetic effects between urethane and chloral hydrate in rabbits with ileal neobladder. METHODS:Eighteen rabbits were randomly assigned to urethane and chloral hydrate groups, and were respectively anesthetized with 20% urethane 5 mL/kg and 10% chloral hydrate 2 mL/kg through the ear vein. Double ureter was dissociated at 1 cm outside original bladder, and 15 cm-intestine obtained from 10 cm of ileocecal junction was implanted so as to establish models of ileal neobladder. RESULTS AND CONCLUSION:Heart rates were significantly lower compared with these before anesthesia in al cases (P≤ 0.05), but no differences were detected between two groups (P > 0.05). Compared with the chloral hydrate group, the maintain time and recovery time were longer and the mortality rate was higher in the urethane group. Above data indicated that chloral hydrate is a safe long-acting anesthetic in establishing rabbit models of ileal neobladder.

Animals ; Ants ; Fatigue ; prevention & control ; Liver ; enzymology ; metabolism ; Mice ; Physical Conditioning, Animal ; Swimming ; Tissue Extracts ; administration & dosage ; pharmacology

Objective To discuss the effects of Deming cycle on reducing adverse drug reactions (ADR) induced by injections of traditional Chinese medicine (TCM).Methods The TCM injections which induced much more ADRs in 2013 were selected. The usage of these TCM injections and characteristics of the ADRs were analyzed. Strategies for controlling ADRs were developed according to Deming cycle and put into the recycle implementation in 2014. Results The ADRs induced by TCM injections were all reduced; the number of total cases was reduced by 41.3% compared to 2013, among which Tanshinone IIA Sulfonate injection,Xinmailong injection, Mylabris injection,Shenqi Fuzheng injection andShengmai injection were reduced significantly, and their reduction rates were all more than 50%. The clinical manifestations of ADRs, including rash, itching, chills, fever, phlebitis, chest distress and palpitation, were all reduced in 2014 compared to 2013, among which especially the allergic reactions, including phlebitis, rash and itching, were reduced by 14.9% and 13.4%.Conclusion Application of Deming cycle in the practice of TCM injections for clinical rational medication can effectively reduce the occurrence of ADRs and better ensure the safety of clinical use of TCM injections.

Objective To explore the relationship of content of plasma endothelin(ET)-1 with the change of pulmonary function in patients with chronic obstructive pulmonary disease(COPD).Method Thirty cases of the normal people were as group A ,34 cases of the patients with COPD with acute exacerbation before treatment were as group B and the patients with remission period after treatment were as group C,the plasma ET-1,arterial blood gas and pulmonary function parameters were determined from the patients before and after treatment.Results The plasma ET-1 in group B and group C were significantly higher than that in group A,the content of the plasma ET-1 had negatively correlated with PaO2,and that had positively correlated with PaCO2,P＜0.01.The pulmonary function parameters (VC,FEV1/FVC,MVV,V50 V25)in group B were significantly lower than those in group A and group C[(55.3±24.5)%,(54.8±19.3)%,(54.2±16.2)%,(54,8±9,9)%,(58.7±14.5)%;(114.8±24.1)%,(84.9±21.6)%,(86.4±17.2)%,(78.5±14.8)%,(90.3±15.4)% and (110.1±19.4)%,(85.8±15.5)%,(85.9±16.7)%,(74.5±13.4)%,(89.4±18.6)%,respectively],P＜0.01.Conclusion Pathophysiological effects of patients with COPD can be commonly adjusted by the plasma ET-1,oxygen and carbon dioxide retention,which affect pulmonary function.

OBJECTIVETo investigate the changes in the levels of monocarboxylate transporter-2 in spinal cord horn in a rat model of chronic inflammatory pain.

METHODSMale SD rats weighting 180 - 220 g were randomly divided into two groups(n = 48): normal saline group (NS group), complete Freund's adjuvant group (CFA group). Rats were given injections of CFA 100 µl in left hind paw in group CFA, and an equal volume of saline was given injection in group NS. Mechanical withdraw threshold(MWT) and thermal withdraw latency(TWL) were measured at before injection(T0 and 3 h, 1 d, 3 d, 7 d, 14 d, and 21 d after injection(T1-7). Four rats were chosen from each group at T0-7 and sacrificed, and L4-5 segments of the spinal cord horn were removed for measurement of the expression of monocarboxylate transporter-2 by Western blot analysis.

RESULTSIn CFA group, mechanical hyperalgesia and allodynia appeared on the 3 h after CFA injection, then until the day 14. The expression of monocarboxylate transporter-2 in the spinal dorsal horn of rats in CFA group was significantly higher than that in normal control group at T1-6(P <0.05). The protein level of monocarboxylate transporter-2 was apparently correlated with MWT and TWL(P <0.01 and P <0.05) in CFA group.

CONCLUSIONThe level of monocarboxylate transporter-2 in spinal dorsal horn is significantly increased in a rat model of chronic inflammatory pain and the change may involve in the formation and maintenance of central sensitization in spinal cord of chronic inflammatory uain.

Animals ; Disease Models, Animal ; Freund's Adjuvant ; Hyperalgesia ; chemically induced ; Inflammation ; chemically induced ; metabolism ; Male ; Monocarboxylic Acid Transporters ; metabolism ; Pain ; chemically induced ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; metabolism ; physiopathology

Carrier Proteins ; metabolism ; physiology ; HIV-1 ; physiology ; Models, Biological ; Proteins ; metabolism ; physiology ; Retroviridae Infections ; virology

Objective:To observe the effect of acupoint massage plus acupoint sticking therapy for the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery.Methods:A total of 120 patients undergoing nasal endoscopic surgery were included,and all patients were under trachea intubation and general anesthesia.The patients were randomized into an observation group and a control group,with 60 patients in each group.Patients in the control group received conventional anesthesia resuscitation,while patients in the observation group received acupoint massage plus acupoint sticking therapy on the basis of conventional anesthesia resuscitation.Changes in the heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed at three time points including the end of the surgery (TO),the removal of the tracheal tube (T1) and 10 min after the removal of the tracheal tube (T2).The awakening and tube removal time,choking cough and restlessness,and adverse reactions (dizziness,nausea and vomiting) in 24 h post-surgery period were compared.Results:At T1 and T2,the comparisons of HR,SBP and DBP between the two groups showed statistical significance (all P＜0.05).Intra-group comparisons showed that the HR,SBP and DBP of the control group at T1 and T2 were significant different from those at TO (all P＜0.05).There were significant differences in the awakening time and tube removal time between the two groups (both P＜0.05).The incidences of choking cough and restlessness were 8.3％ and 3.3％ respectively in the observation group,versus 53.3％ and 30.0％ in the control group,and the between-group comparisons showed statistical significance (both P＜0.05).The incidences of dizziness,nausea and vomiting in 24 h post-surgery period were 3.3％,5.0％ and 0.0％ respectively in the observation group,versus 43.3％,33.3％ and 25.0％ in the control group,and the between-group comparisons showed statistical significance (all P＜0.05).Conclusion:Acupoint massage plus acupoint sticking therapy can effectively regulate the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery,and maintain a stable internal environment.

ObjectiveTo investigate the consistency between the results of passive particle agglutination test ( PPA ) and ELISA on Mycoplasma pneumonia ( M.pneumonia ) infection.Study the diagnostic value of both assays.Methods From November 2010 to May 2011,the serum samples of ]191 patients with respiratorysymptoms were collected fromAffiliatedHospitalof JiningMedical University.All samples were tested for antibody levels against M.pneumonia using PPA,and for IgM,IgG,IgA subclass using ELISA.The correlation between the results of two methods was evaluated by Kappa test and Spearman rank correlation analysis.The variances of the antibody subclasses among samples with different PPA titers and different age groups were analyzed by Kruskal-Wallis test.The infection status of patients was analyzed based on ELISA results and the clinical relevance of both assays was evaluated in comparison with clinical diagnosis for samples with high PPA titer.ResultsThe level of agreement between the results of PPA and ELISA was 84.3％,with Kappa value of 0.642 ( P ＜0.01 ).The prevalence of IgM and IgA antibody against M.pneumonia was significantly different among samples with various PPA titers ( P ＜0.05 ).The prevalence of IgM subclass was higher in chill and teeuager groups,while that of IgA and IgG were higher in elderly group.Antibody isotyping results suggested that 58.1％ of PPA positive samples (75 cases),especially 96.4％ of samples with high PPA titer ( 27 cases),were of current infection,which was in consistent with clinical diagnosis.ConclusionPPA showed good consistency with ELISA on diagnosis of Mycoplasma pneumonia infection.Antibody subclass determination hy ELISA indicates disease progression,thus to differentiate current infection from past.

Objective To establish a method of gene mutation detection for congenital adrenal hyperplasia (CAH) by using sequencing, single nucleotide polymorphisms (SNP) analysis and T-A cloning. Methods The blood samples of 33 patients with 21-hydroxylase deficiency (21-OHD) , 2 patients with 17α-hydroxylase deficiency (17-OHD) , the parents of all the patients and 105 healthy children were collected. Genomic DNA were extracted form the blood samples. To detect the gene mutation of CYP21A2,highly specific primers for CYP21A2 gene were designed according to the sequence differences between CYP21A2 gene and its pseudogene. The whole CYP21A2 gene was amplified and sequenced. SNP analysis and TA cloning of PCR products were also carried out. The molecular diagnosis of 17-OHD was based on the amplification and sequencing of CYP17A1 gene. Results The corresponding gene mutations was determined in all the patients based on the method established in this study. Thirteen mutations of CYP21A2 gene were identified in 33 patients with 21-OHD. The 3 most frequent mutation of CYP21A2 gene were IVS2-13A/C >G, p. I172N and chimeric mutation, which accounted for 32% (21/66) ,27% (18/66) and 15% (10/66) respectively. Ninety-one persent mutations of CYP21A2 gene resulted from pseudogene conversion. In 2 patients with 17-OHD, homozygous mutations of CYP17A1 gene, IVS4-6A > G and p. 487_489del were identified separately. All the gene mutations detected in the patients were inherited from their parents. No mutation of CYP21A2 gene or CYP17A1 gene was found in the healthy children. Conclusion A method of gene mutation detection for CAH has been established. It will be beneficial to clinical diagnosis of CAH.