The myocardial protection technique of off-pump coronary artery bypass grafting ( OPCABG ) has been applied to the coronary artery bypass grafting (CABG) with heart valve surgery.This study is aimed at determining its clinical effect .A retrospective analysis design was adopted .39 patients were recruited .All patients ’ surgeries went smoothly but one ,whose blood pressure was in poor control after surgery and then returned to normal after as -sisted with intra-aortic balloon counterpulsation (IABP).Others had stable vital signs and circulation .Finally,all pa-tients discharged safely .Significant improvement can be seen during 3 months’ follow-up.Applying OPCABG to CABG with heart valve surgery has been proved effective in clinic .

Objective To investigate the clinical appliance value of plantar pressure measurement in hemiplegic patients with acute cerebral infarction(ACI).Methods Plantar pressure was measurered and recorded by the means of Germany-made Zebris in 21 hemiplegic patients with ACI before and 30 d after treatment.Results Although plantar pressure on foot of the paralysed side was found remarkably decreased compared to that of the contralateral side before treatment(all P

Objective To investigate the changes of perioperative right ventricular function after pulmonary resction. Methods 45 cases of pulmonary resection were divided into four groups.Group Ⅰwas wedge resection(n = 10), GroupⅡ was lobectomy(n = 19), Group Ⅲ was double lobectomy(n=7)and Group Ⅳ was pneumonectomy(n=9). The changes of CVP, PAMP, PEP/ET, Sa, VTIs, RVSP, Ea/Aa, and Tel were evaluated by traditional ultrasonic and tissue Doppler ultrasonic techniques at different time inter- vals (pre-operation, 5-7 days orland 1 month post-operation), Results Compared with the pre-operation CVP, the indexes of all groups have no significant changes post-operatively. Wedge resection didn' t obviously influence right cardiac after load and systolic function/diastolic function. No evidet changes detected in Tei pre-and post-operatively. However, the indexes (PAMP, RVSP and PEP/ET ratio) reflecting right cardiac afterload evidently increased at post-pneumonectomy or lobectomy group5- 7 days post-opera- tive. All these reflect the decrease of Tei, which was more obvious in pneumonectomy than in lobectomy group. Right cardiac after- load, systolic/diastolic function and Tel index recovered to pre-operative level 1 month post-operation in single lobectomy group. But the above indicators, especially the Tel, were still high in double lobectomy and pmeunonectomy groups 1 morth post-operation.Tei index is positively correlated with PAMP and is weakly correlated with PET/ET ratio and Ea/Aa ratio. Conclusion Pulmonary wedge resection doesn't evidently influence right cardiac function. However, right cardiac diastolic function evidently decreases temporarily at lobectomy group. The systolic function and diastolic funetions decrease after double-lobectomy and pneumonectomy and it's more evident in pneumonectomy group. Though the right cardiac afterloads of lobectomy, double lobectomy and pneumonectomy groupa all increase significantly post-operativlye, only the former recover to pre-operative level 1 month after surgery.

120 age- and body mass-matched Lewis rats underwent anastomosis of vessels and bronchus using cuff technique and 60 rats received orthotopic left lung transplantation. All procedures were done by one operator. The feasibility and reliability of this technique was determined by examining graft patency usng X-ray, gross and histological examinations. The successful rate of the surgery was 96.7%, mean warm ischemic time was (14.5±3.2)min. On gross examination, grafts were well perfused and ventilated.Recipients of 14d after transplantation showed excellent chest X-ray signs and perfect graft function. The animal model established in this study has been verified to be a safe, simple and reproducible model.

Objective To evaluate the influence of precise liver resection techniques on intestinal permeability in the diseases needing liver resection.Methods Eighty-seven patients needing liver resection were randomized to receive the precise liver resection (n =58,PLR group) or the conventional liver resection (n =29,CLR group).D-lactate and and endotoxin in abdominal fluid were detected in all the patients.The abdominal fluid bacteria cultures were performed.Results The postoperative hospitalization time,the needed time of blood routine,temperature,and oppetite resuming were significantly shorter in PLR group than those in CLR group (t ≥7.36,P ＜ 0.01) ; The postoperative abdominal effusion was significantly less in PLR group than that of CLR group(t ≥ 14.17,P ＜0.01).The abdominal fluid concentrations of D-lactate and endotoxin in operation or at 1d after operation were significantly higher than those at 5d after operation in both groups(t ≥10.41,P ＜0.01).Those parameters decreased significantly at 2d after operation,returned to the normal level at 3d after operation in PLR group,and those parameters were significantly lower in PLR group than those in CLR group at the same time phase after postoperative 2 or 3 days (t ≥9.23,P ＜0.01) ; Those parameters began to drop at 3d after operation,returned to the normal level at 5d after operation in CLR group.The positive rate of abdominal fluid bacteria cultures was significantly lower in PLR group than that in CLR group(13/29) (x2 =23.51,P ＜ 0.01).Conclusions The precise liver resection techniques had an important influence on intestinal permeability in the diseases needing liver resection.

The clinical characteristics, laboratory tests, treatment and prognostic characteristics of a case of neurexin-3α antibody-mediated autoimmune encephalitis,who was admitted in Xi′an International Medical Center Hospital on January 4, 2020 were summaried. The patient was a 56-year-old male with pre-symptoms of infection before his illness. The main manifestations were rapid progress of cognitive dysfunction, mental and behavioral abnormalities, refractory epilepsy, and status epilepticus, dystonia, accompanied by autonomic nerve involvement such as increased heart rate, breathing, and sweating, suspected of central hypoventilation, clinical manifestations were similar to N-methyl-D-aspartate-receptor (NMDAR) encephalitis and magnetic resonance imaging suggested bilateral hippocampal, temporal, and insular high signals, cerebrospinal fluid examination and other laboratory tests were normal. After treatment with methylprednisolone and intravenous immunogloblin, he died a few days after being discharged. The clinical manifestations of neurexin-3α antibody-mediated autoimmune encephalitis were similar to NMDAR encephalitis and severe, and neurexin-3α antibodies need to be further tested to confirm the diagnosis when NMDAR antibody was negative.

Background and purpose:Five-year survival rate of post-operation patients with non-small cell lung cancer(NSCLC)is less than 40%.Treatments after recurrence are difficult.Our study aimed to evaluate the efficacy of pemetrexed on postoperative recurrence of NSCLC.Methods:From Jan.2006 to Sep.2008,40 NSCLC with postoperative recurrence were observed.All patients had received pemetrexed(ALIMTA)500 mg/m2 or carboplatin eonbined.Results:Among the 40 patients,partial response in 10 patients(25.00%),stable disease in 19 patients(47.50%),progressive disease in 11 patients(27.50%).The total response rate was 25.00%and clinical benefit control rate was 72.50%.Pemetrexed had significantly better disease control rate in female than in male (9 1.30% vs 47.06%,P=0.034),in adenocarcinoma patients than in non-adenocarcinoma's(87.10% vs 22.22%,P=0.001).Median overall survival time(MST)was 10.70 months.Progression-free survival time(PFS)was 5.18 months.Adenocarcinoma patients had longer PFS than non-adenocarcinoma patients.Conclusion:Pemetrexed demonstrates significant antitumor activity and good tolerance in these patients.

Objective In order to improve cirrhotic liver management,each aspect of the liver's complex blood flow must be understood.This study investigates the protective effect of portal vein occlusion,with hepatic artery preservation,on cirrhotic liver after ischemia and reperfusion.Methods Carbon tetrachlorideand induced cirrhotic rats and normal rats were randomly assigned into 4 groups:normal sham operation (N-SO),cirrotic sham operation (C-SO),portal triad clamping (PTC),and portal vein clamping without hepatic artery inflow control (PVC).During the occlusion,the total 3-minute blood loss from the liver surface cut was weighed.At 1,6,and 24 hours post reperfusion,the serum alapine amino transferas (ALT),the adenosine triphosphate (ATP) of liver tissue,the malonolialdehgde (MDA) of liver tissue,and the morphological changes were evaluated.Result The amount of hemorrhage between the groups ranked as follows:PTC ＜ PVC ＜ N-SO ＜ C-SO (P＜0.05).At 1,6,and 24 hours post reperfusion.the ALT and MDA levels of the groups ranked as follows:PTC ＞ PVC ＞ C-SO ＞ N-SO (P＜0.05).Additionally,each group's ATP level ranked as follows:PTC ＜ PVC ＜ C-SO ＜ N-SO (P＜0.05).With histopathological examination,the hepatic injuries of the PTC and PVC group were more severe than those of the C-SO group,especially in the PTC group.Conclusion Therefore,the technique of portal vein clamping and hepatic artery inflow control can reduce the ischemic reperfusion injury of the cirrhotic rats' liver.

The previous pharmacokinetic methods can be only limited to drug analysis in vitro, which provide less information on the distribution and metabolismof drugs, and limit the interpretation and assessment of pharmacokinetics, the determination of metabolic principles, and evaluation of treatment effect. The objective of the study was to investigate the pharmacokinetic characteristics of gene recombination angiogenesis inhibitor Kringle 5 in vivo. The SPECT/CT and specific 131I-Kringle 5 marked by Iodogen method were both applied to explore the pharmacokinetic characteristics of 131I-Kringle 5 in vivo, and to investigate the dynamic distributions of 131I-Kringle 5 in target organs. Labeling recombinant angio-genesis inhibitor Kringle 5 using 131I with longer half-life and imaging in vivo using SPECT instead of PET, could overcome the limitations of previous methods. When the doses of 131I-Kringle 5 were 10.0, 7.5 and 5.0 g/kg, respectively, the two-compartment open models can be determined within all the metabolic process in vivo. There were no significant differences in t1/2α, t1/2β, apparent volume of distribution and CL between those three levels. The ratio of AUC(0 ? 1) among three different groups of 10.0, 7.5 and 5.0 g/kg was 2.56:1.44:1.0, which was close to the ratio (2:1.5:1.0). It could be clear that in the range of 5.0–10.0 g/kg, Kringle 5 was characterized by the first-order pharmacokinetics. Approximately 30 min after 131I-Kringle 5 was injected, 131I-Kringle 5 could be observed to concentrate in the heart, kidneys, liver and other organs by means of planar imaging and tomography. After 1 h of being injected, more radionuclide retained in the bladder, but not in intestinal. It could be concluded that 131I-Kringle 5 is mainly excreted through the kidneys. About 2 h after the injection of 131I-Kringle 5, the radionuclide in the heart, kidneys, liver and other organs was gradually reduced, while more radionuclide was concentrated in the bladder. The radionuclide was completely metabolized within 24 h, and the distribution of radioactivity in rats was similar to normal levels. In our study, the specific marker 131I-Kringle 5 and SPECT/CT were suc-cessfully used to explore pharmacokinetic characteristics of Kringle 5 in rats. The study could provide a new evaluation platform of the specific, in vivo and real-time functional imaging and pharmacokinetics for the clinical application of 131I-Kringle 5.

Objective To study how to improve the safety of the operation for abdominal aortic aneurysm(AAA).Methods Forty-six cases of AAA received resection of AAA plus artificial blood vessel transplantation in recent three and a half years in our 2 hospitals.The lesions involved only the abdominal aorta in 20 cases,and extended to unilateral common iliac and internal and external iliac arteries in 8 cases,to bilateral common iliac and external and internal iliac arteries in 16 cases,and involved the renal artery in 2 cases.Emergency operation was done in 3 cases.Results In these 46 cases,45 were cured and 1 died,and no operative complications occurred.Conclusions Surgical operation is the best way to treatment AAA.