Objective To study the effects of atorvastatin on expression of lysyl oxidase(LOX) in myocardial tissue of rats with diabetic cardiomyopathy (DCM) and its mechanism.Methods Thirty DCM SD rats were randomly divided into 3 groups:DCM group,treatment group (atorvastain 2 mg · kg-1 · d-1 by gastric gavage) and β-aminopropionitrile group(β-aminopropionitrile 80 mg · kg-1 · d-1 by gastric gavage),10 cases in each group.Other 10 SD rats were selected as the control group.At the end of week 8,the rats were killed for extracting the myocardial tissue RNA and protein.Expression levels of LOX,MMP-2 and NF-κB mRNAs and proteins in myocardial tissue of DCM rats were measured by RT-PCR and Western blot.Results The expression levels of LOX,MMP-2 and NF-κB mRNAs and proteins in the DCM group were significantly higher than those in the control group (P＜0.01),and compared with the DCM group,the expression of BAPN LOX,MMP-2 and NF-κB mRNA and proteins in the treatment group were significantly deceased (P＜0.01).Conclusion Atorvastatin can reverse the expression of LOX in myocardial tissue of DCM rat,and then may regulate the expression of MMP-2 and NF-κB.

Objective: Pocket infection in patients after total removal of implanted pacemaker has many problems for their electronic system; our research intends to explore the feasibility of conservatively treating such infection and retain the electronic system. Methods: A total of 4 patients with pacemaker pocket infection in our hospital from 2015-01 to 2016-02 were studied. Thorough debridement and disinfection were conducted in infected pockets and devices, meanwhile vacuum sealing drainage was applied. Electrode wire was kept and intravenous antibiotics were given for (7-10) days after the operation in all patients. Results: The average time of infection occurred at 14.75 months after operation with the type of isolated pacemaker pocket infection. Pocket vacuum suction drainage was performed, with the mean of 7.25 (5-10) months follow-up observation, infection was disappeared and the patients had good wound healing. Conclusion: With thorough debridement of infected pocket, rational treatment of residual electronic system and vacuum sealing drainage, the infection might be effectively controlled for complete recovery without lead extraction in relevant patients.

AIM:To investigate the effect of calcitonin gene-related peptide (CGRP)transfection into c-kitpos cardiac stem cells (c-kit+CSCs) on the cell viability.METHODS: Under the sterile condition, the auricles of SD rats were taken out , and then c-kit +CSCs were collected through enzyme digestion and immunomagnetic bead separation (MACS).The cells were identified by flow cytometry .c-kit +CSCs were transfected with enhanced green fluorescent pro-tein CGRP lentiviral vector ( Lv-EGFP-CGRP) or enhanced green fluorescent protein lentiviral vector ( Lv-EGFP).The cells were randomly divided into Lv-EGFP-CGRP-CSCs group , Lv-EGFP-CSCs group and CSCs group .The transfection was observed under the fluorescence microscope .The transfection efficiency was detected by flow cytometry .The CGRP protein secretion in the cell culture supernatants was detected by ELISA .The viability of c-kit+CSCs transfected with Lv-EGFP-CGRP or Lv-EGFP was measured by CCK-8 assay.RESULTS:c-kit+CSCs were isolated and cultured successfully .The expression positive rate of c-kit was 91.0%and the expression positive rates of CD 45 and CD34 were 4.5% and 4.0%, respectively.After transfected with lentivirus for 48 h, the stable fluorescence in c-kit +CSCs was observed under fluores-cence microscope .The transfection efficiency were 80%when MOI was 20.The level of CGRP was significantly increased in Lv-ECFP-CGRP-CSCs group compared with Lv-EGFP-CSCs group and CSCs group (P<0.05).Meanwhile, transfection with lentiviral vector in each group did not affect the viability of c-kit+CSCs.CONCLUSION:Transfection of Lv-EGFP-CGRP into c-kit+CSCs was successful .The secretion of CGRP was found in the transfected c-kit+CSCs and the viability was not changed after transfection .CGRP-modified c-kit+CSCs may play a role in treating myocardial infarction .

ObjectiveTo explore the clinical significance of arterial portography in the diagnosis an d management of prehepatic type portal hypertension(PHPHT). Met hodsBetween 2000 to 2002, all the 11 patients with PHPHT were dia gnosed by angiography and B type ultrasounography. Different operations were par formed including mesocaval shunt in 5 patients,portal-vena cava shunt in 1, splenorenal shunt in 2,and portoazygos venous disconection in 1. Two patien ts were not operated. Results Nine cases undergoing surgical operations had satisfactory outcome. Conclusions PHPHT can be correctly diagnosed by indirect portal venography which is important for the choice of operation.

Objective To investigate the imaging manifestations of congenital intestinal malrotation. Methods The clinical data of 92 infants with congenital intestinal malrotation admitted from January 1993 to December 2012 were studied retrospectively. All the 92 cases enrolled in this study were diagnosed based on imaging examinations and confirmed surgically. The imaging features of four examinations including plain abdominal radiography, upper gastrointestinal radiography, lower gastrointestinal angiography and ultrasound examination were analyzed. Results The percentage of the infants who presented with the initial clinical symptoms of vomit, blood stool and abdominal dilatation was 87.0%(80/92), 3.3%(3/92) and 1.1%(1/92), respectively, and eight cases [8.7%(8/92)] received prenatal ultrasound, which showed intestinal malrotation. Clinical examination showed no abdominal abnormalities in 68 (73.9%) cases. Seventy-seven cases underwent plain abdominal radiography, revealing intestinal obstruction in 31 cases. Thirty-six cases underwent upper gastrointestinal radiography, which revealed malrotation in 14 cases, and duodenal complete/incomplete obstruction or stenosis in 19 cases. Twenty-two cases underwent lower gastrointestinal angiography, and all of them were diagnosed as malrotation. Seventy-nine cases were examined with abdominal ultrasonography, and 58 cases were diagnosed as malrotation. Conclusions Rational selection of imaging examinations can improve the preoperative diagnosis. When congenital intestinal malrotation is suspected, abdominal ultrasound should be done as the first optional examination. At the same time, plain abdominal radiography should be selected accordingly. When intestinal malrotation with or without midgut volvulus is suggested, surgery should be performed as early as possible. When the diagnosis is not clear, upper or lower gastrointestinal radiography should be done.

ObjectiveTo sum up the experience in the treatment of huge primary retroperitoneal pelvic tumors (diameter≥10 cm), and analyze factors influencing the removal of the tumors during surgical procedures. MethodsA clinical retrospective review of 26 cases with huge primary retroperitoneal pelvic tumors undergoing surgical resection was made during a period of 1980～2000 in our hospital. The rate of tumors resected was compared between benign and malignant, male and female patients. Results The tumor resection rate in this group was 73%(19/26). There was no mortality within 30 days and no severe postoperative complication. Conclusion Resection should be attempted whenever possible for patients suffering from huge pelvic tumors. The resection rate was higher in female patients than that in male patients. Major blood vessels invasion is responsible for low radical resection rate.

Objective To evaluate the result of revascularization for lower limb artery ischemia in elder patients. Method During Jan 2006 to Nov 2008, 262 elder patients (60 years old and up), underwent artery revascularization for lower limb arterial ischemia. Mortality, morbidity, primary patency, secondary patency and limb salvage were analyzed. Result There were a total of 323 ischemia limbs in those 262 elder patients undergoing revascalarization, among those 102 limbs underwent artery bypass, 98 limbs underwent endoluminal angioplasty with or without stenting, 67 limbs underwent embolectomy or endarterectomy, 56 limbs underwent open surgery combined with endoluminal treatment due to multiple segment lesions. Operation success rate was 94.7%. Two patients died within 30 days. Perioperative morbidity developed in 15 cases. 245 patients (93.5%) were followed-up from 1 month to 35 months. Mortality was 6.1% (15 cases), primary patency was 80.5%, secondary patency was 92.7% and limb salvage rate was 95.2%. Risk factors analysis showed that history of cardiac disease and elder ages were associated with higher mortality. Diabetes mellitus, critical ischemia and multiple segment lesions were associated with poor long term patency and limb salvage. Conclusion Lower limb ischemia is severe disease related to elder patients' death and amputation. Careful patient selection, detailed pre-operation work-up, meticulous operative technique play crucial roles for a successful arterial reconstruction.

Objective To evaluate the efficacy and safety of perioperative anticoagulation and antiplatelet therapy of carotid endoarterectomy (CEA). Methods A retrospective study on 110 cases (122 CEAs) of carotid stenosis between Jan 2004 and Dec 2008 was undertaken. 122 cases were divided into anticoagulation group and antiplatelet group according to the perioperative medical treatment. Postoperative results of stroke/death and wound hemotoma were compared between the two groups and statistically analyzed. Results 45 CEAs were given perioperative combination of anticoagulation and antiplatelet treatment. This comprised the anticoagulation group. The antiplatelet group consisted of the other 77 CEAs which were treated with antiplatelet solely. Perioperative stroke/death rates were equivalent (2.2% anticoagulation vs. 2.6% antiplatelet, P =0.897). Wound hemotoma rates were found with statistical significant difference between the two groups (13.3% anticoagulation group vs. 1.3% antiplatelet group, P = 0. 006 ). Conclusion Our results suggest that perioperative antiplatelet therapy in perioperative carotid endoarterectomy does not increase perioperative stroke/death risk, while perioperative anticoagulation increases the risk of wound hematoma.

Objective To analyze the use of hypoglycemic agents of diabetic adult patients who were managed in the Community Health Service Center of Huazhong University of Science and Technology in Wuhan .Methods By analyzing of fol-low-up record of 647 adults with diabetes of the Community Health Service Center outpatient in 2014 to understand about their drug use .Results The ages of prevalence of adult diabetes were 50 to 79 years old (79 .29% ) ,of which the majority of pa-tients aged 60 or older (73 .11% ) ,men are more than women ;the using of antidiabetic monotherapy accounted for 61 .36% , the two drugs together accounted for 34 .93% ,and three or more drugs accounted for 3 .71% ;α-glucosidase inhibitors ,met-formin ,insulin secretagogues are the highest frequency of use ;outpatient diabetics administered orally based .Conclusion The medication use of diabetes in this community was consisted with the requirement of ChinaGuideline for Type 2 Diabetes (2013 edition) .

OBJECTIVETo study the application of hand-assisted laparoscopic surgery (HALS) in colorectal carcinoma resection.

METHODSFourteen patients with colorectal carcinoma underwent resection by HALS.

RESULTSHand-assisted laparoscopic right hemicolectomy was performed in 6 of 8 ascending colon cancer patients, spending an average of 160 minutes (110 to 220 minutes) for the procedure. The amount of bleeding was 40 approximately 100 ml. Bowel sounds resumed in 36 approximately 72 hours after the operation. The average interval between the operation and patients' discharge was 8 days (7 to 12 days). For 2 patients the surgeons had to resort to laparotomy. All patients received postoperative chemotherapy. Hand-assisted laparoscopic abdominoperineal resection was performed in 5 of 6 patients with lower rectal cancer, with the average duration of 180 minutes (120 to 270 minutes), with bleeding of 40 to 80 ml. Bowel sounds resumed within 24 to 72 hours and the average discharge interval was 14 days (12 to 18 days). The urinary catheter in 6 patients was removed in 7 to 8 days after the operation. All patients with rectal carcinoma received postoperative chemotherapy and radiotherapy. One patient was shifted to laparotomy because of extensive adhesion in the pelvic cavity. Four of 11 patients treated by HALS experienced slight pain in the incision. No other complications were observed in any of the patients. Remote results await further follow-up.

CONCLUSIONHand-assisted laparoscopic surgery in the treatment of colorectal carcinoma, a safe and simple procedure, not only ensures the clearance of tumor, but also reduces operative trauma and hastens recovery.

Adult ; Aged ; Colectomy ; Colorectal Neoplasms ; surgery ; Female ; Hand ; Humans ; Laparoscopy ; Male ; Middle Aged ; Treatment Outcome