ObjectiveThe present study was designed evaluate the aspirin effectiveness in the inhibition of platelet aggregation in patients after OPCAB.Methods290 patients were recruited.145 patients underwent first time OPCAB (surgery group).Arachidonic acid induced platelet aggregation and urine 11-dehydro thromboxane B2 (11-dehydroTxB2) were measured before operation and on aspirin re-administered days 1,4, 10, and 6 months after surgery.The same tests were also detected in 145 patients from the cardiology department (non-surgery group) received medicine therapy as controls.Results Ninety-nine patients were defined as aspirin sensitive after OPCAB (AS Group).Postoperative aspirin resistance was identified in 46 (32％) patients at the first day after aspirin treatment started (AR Group).19 (13％) and 5 (3％) patients remained as AR at day 4 and 10 after aspirin re-administration, respectively.Patients in the AR group had higher 11-dehydroTxB2 levels than those in the AS group (P = 0.049).Six months follow-up showed ARA-induced platelet aggregation was (11.5 ± 3.4) ％.Urine level of 11-dehydroTxB2 was (50.3 ± 15.4) ng/L.No resistance was found.All cardiologic patients were identified as aspirin sensitive, the change of platelet aggregation and 11-dehydroTxB2 were similar as those in the AS group.Weight ＞75 kg and postoperative drainage ＞500 ml were risk factors of aspirin resistance after OPCAB.ConclusionAnti-platelet effect of aspirin was reduced during the early postoperative period in certain patients undergoing OPCAB.In case of resistance,antiplatelet treatment strategy should be intensified or modified.

Objective:To assess aspirin efficacy in the early postoperative period following off-pump coronary artery bypass(OPCAB)surgery.Methods:Sixty patients undergoing OPCAB surgery were enrolled in the study.Previous aspirin treatment Was terminated 5-7 days before OPCAB and continued to take at the day with food intake after surgery.The functional and biochemical responses to aspirin were evaluated by arachidonie acid (ARA)-induced platelet aggregation.Samples were collected before and on days 1,4 and 10 after aspirin intake(100 mg/d).Results:There were 17 patients(28.3%),9 patients (15%)and 2 patients(3.3%)with aspirin resistance on day 1,4 and 10 of aspirin intake.The overall levels of platelet aggregation(%)were 63(52,70),13(11,22),12(10,14),and 12(11,14)before the surgery and on day 1,4 and 10 of aspirin intake.The level was stable from the 4th day after aspirin intake.It was found that aspirin resistance was not an independent risk factor for the operation.Conclusion:Aspirin did not sufficiently inhibit platelet aggregation at the early stage after OPCAB.It is important to keep potential anti-coagulation therapy in the early postoperative period.

Objective To explore the changes of QRS combined data and myocardial enzymes during ischemia-reperfusion in rabbits,and observe the changes of ST segment and T wave of lead Ⅱ,and arrhythmias.Methods The models of ischemia-reperfusion(A,B,C and D group)were made by ligating the left circumflex territory for 10,20,30,40 min and then reperfusion for 60 min.The sham-operated control was designed.The changes of the QRS combined data,ST segment and T wave and rises of arrhythmias about electrocardiogram of lead Ⅱ were observed.Meanwhile,the activity of serum myocardial enzymes was measured.Results The QRS combined data of the group D was higher significantly than the sham-operated control,group A and group B(P<0.05).T waves of different groups were not significantly different(P>0.05).The J spot elevation of lead Ⅲ in 19 rabbits of the ligating group and 5 rabbits of the sham-operated control was observed before operation.The changes of ST segment were clearly observed in the ligating group after operation:apparent mono-phasic curve elevation in 21 rabbits,level type depression in 2 and no change in 1.ST segment of other animals was declined more than 0.2 mV in 60 min reperfusion,except ST segment of 2 rabbits elevated again more than 0.1 mV,2 rabbits were normal and 1 rabbit was depressed.Two rabbits of the group D respectively died of sinus bradycardia in reperfusion 40 min and 43 min,and two rabbits appeared premature ventricalar contraction during reperfusion 3-5 min.The activity of serum aspartate aminotransferase(AST)and lactate dehydrogenase(LDH)obviously increased in the group D(P<0.05).Creatine kinase(CK)was high significantly except the sham-operated control(P<0.05).The activity of serum CK-MB of the groups C and group D was significantly higher than that of the sham-operated control(P<0.05).Conclusion The rising of LDH,CK-MB and QRS combined date in the group D is related with ischemia-reperfusion injury.

We report here a novel membrane transfer-based DNA detection method, in which alkaline phosphatase labeled gold nanoparticle (AuNP) probes were used as a means to amplify the detection signal. In this method, the capture probe P1, complimentary to the 3' end of target DNA, was immobilized on the chip. The multi-component AuNP probes were prepared by co-coating AuNPs with the detecting probe P2, complimentary to the 5' end of target DNA, and two biotin-labeled signal probes (T10 and T40) with different lengths. In the presence of target DNA, DNA hybridization led to the attachment of AuNPs on the chip surface where specific DNA sequences were located in a "sandwich" format. Alkaline phosphatase was then introduced to the surface via biotine-streptavidin interaction. By using BCIP/NBT alkaline phosphatase color development kit, a colorimetric DNA detection was achieved through membrane transfer. The signal on the membrane was then detected by the naked eye or an ordinary optical scanner. The method provided a detection of limit of 1 pmol/L for synthesized target DNA and 0.23 pmol/L for PCR products of Mycobacterium tuberculosis 16S rDNA when the ratio of probes used was 9:1:1 (T10:T40:P2). The method described here has many desirable advantages including high sensitivity, simple operation, and no need of sophisticated equipment. The method can be potentially used for reliable biosensings.
Colorimetry ; methods ; DNA Probes ; chemistry ; genetics ; DNA, Bacterial ; genetics ; Gold ; chemistry ; Humans ; Metal Nanoparticles ; chemistry ; Mycobacterium tuberculosis ; isolation & purification ; Nucleic Acid Hybridization ; methods ; Oligonucleotide Array Sequence Analysis ; methods

Objective To conduct an epidemiological investigation on a case of familial arsenic poisoning in Yunnan Province,to find arsenic poisoning source and create a archive of typical cases,in order to raise awareness of endemic arsenicosis and provide scientific materials for prevention and treatment of the disease.Methods In Xiaxiaoying Village of Yunnan Province,all members of a family with arsenic poisoning patients were investigated in 2013,their health examination and epidemiological survey of arsenic poisoning were carried out,and arsenic poisoning family profiles and personal files were established.Drinking water,hair and urine samples were collected for arsenic content determination,blood samples were collected for biochemical detection,excessively keratose skin was collected for pathological biopsy.Results A total of 33 family members were investigated.Among them 15 were exposed to arsenic and 18 were not exposed to arsenic.Fifteen people exposed to arsenic were found to be have skin lesions,and two eldest males died of skin cancer and cerebral hemorrhage in 1994 and 2009,respectively.The survey found out that 15 patients born in 1935-1983 had been drinking arsenic pesticides polluted well water for 5 to 16 years from 1973 to 1989.As of 2013,the arsenic exposure had been stopped for 24 years,the content of arsenic in the polluted wells was 0.624 mg/L,which was 62.4 times the recommended maximum limit (0.01 mg/L) of the World Health Organization.The median of hair and urinary arsenic in arsenic exposed population and non-arsenic exposed population was 4.2,3.7 mg/kg and 60.9,41.0 μg/L,respectively.There was no statistically significant difference in hair arsenic (Z =-1.905,P ＞ 0.05),but the difference of urinary arsenic was statistically significant (Z =-3.002,P ＜ 0.05).The median of aspartate aminotransferase (AST),gammaglutamyltransferase (γ-GT) and 24 hours urinary ereatinine (Cr) in arsenic exposed population and non-arsenic exposed population was 37.5,31.0 U/L,25.5,12.0 U/L,13 834.0,and 6 843.0 μmol/L,respectively.The differences between the two groups were statistically significant (Z =-2.776,-2.311,-2.502,P ＜ 0.05).Twelve cases of arsenic poisoned patients who were conducted health examination and epidemiological investigation showed typical triad of skin,among them 2 cases were moderate and 10 cases were severe.Pathological biopsy results showed 8 cases had basal cell carcinoma or squamous cell carcinoma.Conclusions Drinking arsenical pesticide contaminated water can induce chronic arsenic poisoning,even after the cessation of arsenic exposure.We should pay close attention to its long-term serious harmful effect.

Objective:To investigate the application of three-dimensional image reconstruction combined with problem-based learning (PBL) in the teaching of physicians receiving continuing education in thoracic surgery.Methods:A total of 68 physicians who received continuing education in Department of Thoracic Surgery in our hospital were selected as research subjects, and they were divided into control group and observation group using a random number table, with 34 physicians in each group. The physicians in the control group received traditional teaching, while those in the observation group received three-dimensional image reconstruction combined with PBL teaching. A questionnaire survey, theoretical assessment, and assessment of practical skills were performed to evaluate the effect of teaching. SPSS 22.0 was used to perform the t-test. Results:Compared with the control group, the observation group had significantly higher degrees of satisfaction with each item of the questionnaire survey ( P<0.05). Compared with the control group, the observation group had significantly higher scores of theoretical assessment [(94.07±6.03) vs. (86.34±5.46), P<0.001] and the assessment of practical skills [(95.20±5.48) vs. (84.71±6.14), P<0.001]. Conclusion:The application of three-dimensional image reconstruction combined with PBL teaching can help to improve the comprehensive ability of physicians receiving continuing education.

Objective To explore application of our self-designed U-shaped transdermal surgical navigator based on three-dimensional reverse design in cannulated screwing for femoral neck fracture Methods A retrospective study was done of 5 patients with femoral neck fracture who had been treated from August 2016 to March 2017.They were 3 men and 2 women,aged from 33 to 60 years (average,46.5 years).Thin layer CT scanning was conducted on the patients' affected hip (at the left side in 2 cases and at the right side in 3).Based on their CT data,3D design software and 3D printing technique were used to manufacture the U-shaped transdermal surgical navigator and a real-sized model of the fracture.Operations were simulated using the U-shaped transdermal surgical navigator on the fracture model to determine the angle,depth and location of the screwing.Fixation of the fracture with cannulated screws was conducted after confirmation of satisfactory surgical parameters.The postoperative X-ray films of the patients were reviewed.Evaluations were conducted of the screw position,operating time,volume of operative bleeding,and number of intraoperative X-ray shots.Results The screw positions in the 5 patients were consistent with their preoperative design.Four patients had only one shot of fluoroscopy and one patient 3 shots.Their operating time ranged from 15 to 30 minutes,averaging 22.5 minutes;their bleeding ranged from 5 to 10 mL,averaging 7.5 mL.The 5 patients were followed up for an average of 4.5 months (from 3 to 6 months).By the Harris scoring at their final follow-ups,one was excellent,3 good and one fair.No complications like pain,functional impairment of the joint,or collapse or necrosis of the femoral head occurred during the follow-up.Conclusions Our self-designed U-shaped transdermal surgical navigator based on three-dimensional reverse design can significandy improve the accuracy and safety of the cannulated screwing for femoral neck fractures.The operation is minimally invasive,reducing operating time and intraoperative blood loss.

Objective:Using single cell sequencing to analyze the characteristics of the immune repertoire of SARS-CoV-2 pa-tients at different infection stages,and to explore the possible pathogenesis.Methods:Obtaining data in the NCBI database,and healthy control,progression and convalescence groups were set up.Analysis of single cell sequencing data by RStudio,Origin,Hipliot and Excel software.Results:TCR plays an important role in antigen recognition and virus clearance.Characteristics of the three immune repertoires are very different.The number of clones exceeded 26.92%.The length distribution of α chain CDR3 was con-centrated on 14 amino acids,while β-chain was concentrated on 15 amino acids.The frequency of gene fragments in V and J regions were different,and the frequency of TRAV13-1,TRAJ20,TRBV20-1 and TRBJ2-1 were statistically significant(P<0.05).Further V-J gene combination analysis showed that there were significant differences in the frequency of single chain V-J between the control group and the progression group,the control group and the rehabilitation group(P<0.05).The highest frequency of αβ double chain V-J in the control group was TRAV19-J34-TRBV4-1-J2-1,the highest frequency of αβ double-stranded V-J in the progression group was TRAV12-1-J30-TRBV19-1-J2-1,and the highest frequency of αβ double chain V-J in the convalescence group was TRAV12-2-J52-TRBV7-9-J1-5.Conclusion:This study analyzes the global characteristics of T cells in the immune repertoire,which is helpful to understand the pathogenesis of SARS-CoV-2 patients,timely and effective treatment of patients in the early stages of infection.

Background: and Purpose To examine the clinical and safety outcomes after endovascular treatment (EVT) for acute basilar artery occlusion (BAO) with different anesthetic modalities. Methods: This was a retrospective analysis using data from the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) registry. Patients were divided into two groups defined by anesthetic modality performed during EVT: general anesthesia (GA) or non-general anesthesia (non-GA). The association between anesthetic management and clinical outcomes was evaluated in a propensity score matched (PSM) cohort and an inverse probability of treatment weighting (IPTW) cohort to adjust for imbalances between the two groups. Results: Our analytic sample included 1,672 patients from 48 centers. The anesthetic modality was GA in 769 (46.0%) and non-GA in 903 (54.0%) patients. In our primary analysis with the PSM-based cohort, non-GA was comparable to GA concerning the primary outcome (adjusted common odds ratio [acOR], 1.01; 95% confidence interval [CI], 0.82 to 1.25; P=0.91). Mortality at 90 days was 38.4% in the GA group and 35.8% in the non-GA group (adjusted risk ratio, 0.95; 95% CI, 0.83 to 1.08; P=0.44). In our secondary analysis with the IPTW-based cohort, the anesthetic modality was significantly associated with the distribution of modified Rankin Scale at 90 days (acOR: 1.45 [95% CI: 1.20 to 1.75]). Conclusion In this nationally-representative observational study, acute ischemic stroke patients due to BAO undergoing EVT without GA had similar clinical and safety outcomes compared with patients treated with GA. These findings provide the basis for large-scale randomized controlled trials to test whether anesthetic management provides meaningful clinical effects for patients undergoing EVT.

OBJECTIVE： To observe the efficacy and safety of apatinib combined with systemic chemotherapy for hepatic metastasis of gastroenteropancreatic neuroendocrine neoplasms （GEP-NEN）. METHODS： Totally 60 patients with GEP-NEN in Hubei Provincial Tumor Hospital from Jan. 2016 to Jan. 2018 were randomly divided into systemic chemotherapy group， apatinib group and combination group， with 20 patients in each group. Systemic chemotherapy group was given Etoposide injection 80 mg/m2，once a day d1-5， intravenously+Cisplatin for injection 20 mg/m2，once a day d1-5，intravenously， every 3 weeks for a cycle. Apatinib group was given Apatinib mesylate tablets 0.5 g， once a day. Combination group received treatment as systemic chemotherapy group+apatinib group. All three groups were treated continuously for 3 months. The clinical efficacies of 3 groups were observed. The serum levels of tumor markers （CEA， NSE， CgA and CA19-9） before and after treatment， survival situation after treatment and the occurrence of ADR during treatment were also observed. RESULTS： The objective remission rate， disease control rate， median overall survival and survival rate of combination group were significantly higher or longer than those of systemic chemotherapy group and apatinib group. Median progression-free survival and the incidence of ADR were significantly shorter or lower than systemic chemotherapy group and apatinib group （P＜0.05）. After treatment， the levels of CEA， NSE， CgA and CA19-9 in 3 groups were significantly lower than before treatment， and combination group was significantly lower than systemic chemotherapy group and apatinib group （P＜0.05）. There was no statistical significance in above indexes between systemic chemotherapy group and apatinib group （P＞0.05）. CONCLUSIONS： Apatinib combined with systemic chemotherapy for liver metastasis of GEP-NEN is effective and safe， which can improve the level of serum tumor markers， prolong the survival time of patients and improve survival rate.