Adult ; Aneurysm, Dissecting ; Humans ; Male ; Pulmonary Artery

Adolescent ; Adult ; Aged ; Blood Urea Nitrogen ; Creatinine ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Kidney ; physiopathology ; Kidney Function Tests ; Male ; Middle Aged ; Phytotherapy ; Renal Dialysis ; Uremia ; physiopathology ; therapy

Objective To summarize the clinical experience of off-pump coronary artery bypass grafting (OPCABG) for treating high risk coronary artery disease (CAD,SinoSCORE ≥ 6 points),and to evaluate its safety and efficacy.Methods The clinical data of 73 patients with high risk coronary artery disease treated through OPCABG (high risk group)in our center from April 2012 to December 2015 were retrospectively analyzed and compared with those of other low or moderate risk 78 patients treated through OPCABG (SinoSCORE＜ 6 points,low or moderate risk group) at the same period.Results All operations in the high risk group were successfully performed.Compared with the low or moderate risk group,the rate of using left internal mammary artery grafts in the high risk group was reduced significantly (P＜0.05),the operation time,postoperative ventilator support time,postoperative intensive care unit stay time and postoperative hospitalization time were prolonged significantly (P＜0.05),the rate of using intraaortic balloon pump support was increased significantly (P＜0.05),and the occurrence rate of postoperative severe complications was also increased significantly (P＜0.05).Sixty-nine cases were postoperatively followed up for (18.3±8.6) months.During the following-up period,2 cases died.11 branches of internal mammary artery grafts patency (11/11) and 38 branches of great saphenous vein grafts patency (38/43) were confirmed in 18 cases by coronary artery computer tomography angiography or coronary angiography.One cases was performed the PCI therapy due to angina relapse,and other cases had no angina symptoms with good life quality.Conclusion OPCABG is a relatively minimally invasive and safe operative mode.Strengthening perioperative management can reduce the operation risk and achieves good short or middle term efficacy in the patients with high risk CAD.

Aim Tostudythetherapeuticeffectof CJ016 on human lung cancer model and the mecha-nism.Methods Anexperimentalhumanlungadeno-carcinoma model of A549 was set up to investigate the anti-tumor effect of CJ016,while the effect of angio-genesis and apoptosis in tumor were detected.Results In vitro,the cell proliferation was inhibited signifi-cantly by CJ016,and the value of IC50 was 34. 22 nmol ·L-1 .In vivo,the tumor inhibition rate and T/C%value were 70. 08%and 27. 75%,respectively,at the dose of 20 mg·kg-1 .Meanwhile,CJ016 could reduce the expression of CD31 and promote the apoptosis of tumorcells.Conclusion CJ016caninhibitthegrowth of A549 cells,and the possible mechanism may be re-lated to the reduction of angiogenesis and inducing tumor cell apoptosis.

Objective To study the effect of percutaneous transhepatic gallbladder drainage (PTGBD) combined with laparoscopic cholecystectomy (LC) in treatment of acute severe cholecystitis.Method The perioperative data of patients treated with PTGBD combined with LC and patients treated with emergency LC were analyzed.Results There were no significant difference between the two groups on surgical duration (t =0.601,P =0.551) and postoperative hospital stay (t =0.979,P =0.331).Blood loss [PTGBD + LC (79.43 ± 46.27) ml,LC (125.84 ± 64.18) ml ; t =3.641,P ＜ 0.05],peritoneal drainage time [PTGDB + LC (3.29 ± 1.58) d,LC (4.63 ± 2.31) d ; t =3.131,P ＜ 0.05] and postoperative oral intake time [PTGBD +LC (2.91 ±1.58)d,LC (4.21 ±2.22)d; t =2.669,P＜0.05] were significantly different between the two groups.The rate of laparotomy,mortality and postoperative complications in the emergency LC group were higher than those in the PTGBD combined with LC group.Conclusions PTGBD combined with LC in the treatment of acute severe cholecystitis was significantly better than emergency LC.

Objective To explore the significance of the plasma procalcitonin (PCT) level for directing antibiotic therapy in elderly patients with ventilator-associated pneumonia (VAP).Methods The 50 elderly patients with VAP were randomly separated into the regular therapy group and the PCT-directed therapy group. The regular therapy group was given regular antibiotic therapy, while the antibiotic therapy was decided according to the plasma level of PCT in the PCT-directed therapy group. The used time and utilization rate of antibiotics, as well as inflammatory indicators including white blood cells, neutrophils, C-reactive protein (CRP) and clinical pulmonary infection score (CPIS) were compared between the two groups. Results After treatment, there were no significant differences in white blood cells, neutrophils and CRP between the PCT-directed therapy group and regular therapy group [(8.9 ± 3.5 ) × 109/L vs. (9.4 ± 3.7) × 109/L, 0.62 ± 0.04 vs.0.60±0.04, (18.7±8.5) mg/Lvs. (21.6±6.0) mg/L, t=0.47, 1.84 and 1.37, allP＞0.05],but the CPIS was markedly lower in PCT-directed therapy group than in regular therapy group [(4.0± 1.4) scores vs. (4.7± 1.0) scores, t= 2. 18, P＜0.05]. The neutrophils, CRP and CPIS were significantly lower after treatment than before in the both groups. The concentration of PCT was decreased after treatment than before [(0.5 ± 0.9) mg/L vs. (1.7 ± 0.7) mg/L]. Meanwhile, the time using antibiotics was longer in regular treatment group than in PCT-directed therapy group [(8.72±1.32) d vs. (5.17±0.72) d, t=11.96, P＜0.01], the utilization rate of antibiotics was higher (95.2 % vs. 55.2 %, χ2 = 12.41, P＜0.01) in regular treatment group. Conclusions Using PCT levels for directing treatment in elderly patients with VAP can achieve better curative effect and reduce the use of antibiotics.

Objective To study ADFR with statin programmed therapy of osteoporosis in ovariectomized rats.Methods Fifty female rats were randomly allocated into 2 groups:sham operation (S, n =10) and OVX ( n =40) group.After operation for one month,OVX were randomly allocated into 4 groups (each n =10):OVX,statins (T),bisphosphonates (B) and statins+bisphosphonates+calcium+vitamin D (ADFR).After feeding statins or bisphosphonates or ADFR for 100 days,all rats were sacrificed.The effects of T or B or ADFR on bone histomorphology or osteocalcin in sera or deoxypyridoxine in urea were studied.Results The data showed that osteocalcin and deoxypyridine in OVX group were significantly improved compared with S group ( P 0 05) ,in B group was decreased,and in ADFR group was increased compared with OVX group.The histomorphometric date showed that TOS,MOSW,STS/DTS,TBOS,TBSC and iMAR in OVX were significantly increased,and TBV,MLT and ? in OVX were decreased,compared with S group.TBV in B,T and ADFR groups was larger than that in OVX group.TOS,MOSW,TBOS and TBCS in B group were smaller than those in OVX group,? in B group was longer than that in OVX group,TBCS and ? in T group were increased compared with OVX group.Conclusion Statins promote bone turnover,increase osteoblast activity and osteoid production,and reduce the bone construction.Bisphosphonates inhibit bone absorption,while ADFR acelerate bone formation and reduce bone loss,suggesting that polytherapy is preferable to monotherapy.

Fecal occult blood test (FOBT) screening has been shown to decrease the incidence and mortality of colorectal cancer (CRC). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the immunochemical fecal occult blood test (i-FOBT) in diagnosing CRC were assessed among the patients in a tertiary referral hospital in Malaysia. A total sample of 814 patients aged 16 to 85 years old who performed i-FOBT and endoscopic screenings was obtained. The patients were recruited for a retrospective investigation. Sensitivity, specificity, PPV, and NPV were derived for the CRC screenees. Out of the 814 patients screened using i-FOBT, half of them were above 59 years old (49.6%), and 36% had positive i-FOBT. Gender distribution was almost equal, where 53.4% of the patients were female, and 46.6% were male. Majority of the patients were Malays (56.6%), followed by Chinese (24.0%), Indians (16.5%), and others (2.9%). Among the 71 patients referred for colonoscopy, 57.7% and 42.3% corresponded to positive and negative i-FOBT cases, respectively. Polyps were found to be most common among the patients (25.6%), 7.0% were found positive for invasive CRC, and 35.2% had normal colonoscopic findings. There was a significant association between colonoscopic finding and positive i-FOBT (p=0.001). The sensitivity, specificity, PPV, and NPV for CRC detection were 66.7%, 43.0%, 9.8%, and 93.3%, respectively. The results indicate that i-FOBT is a useful tool in the detection of abnormalities in the lower gastrointestinal tract and therefore serves as a cornerstone for potential large-scale screening programmes.

Objective To evaluate our self-designed guide used clinically in percutaneous placement of lumbosacral pedicle screws in surgery of lumbar vertebral fractures.Methods From May 2012 to March 2015,143 patients with lumbar vertebral fracture were treated with reduction and fixation using percutaneous lumbosacral pedicle screws in our department.Percutaneous placement of lumbosacral pedicle screws was assisted by our self-designed guide in 69 of them(guide group) but not in the other 74 cases (manual group).The 2 groups were compatible in preoperative general data (P ＞ 0.05).The 2 groups were compared in terms of localization time for a single screw,puncture accuracy,times of intraoperative fluoroscopy,operation time,intraoperative blood loss,and hospital stay.Results The guide group had significantly better localization time for a single screw,puncture accuracy,times of fluoroscopy and operation time than the manual group (P ＜ 0.05),but the 2 groups showed no significant differences in intraoperative blood loss and hospital stay (P ＞ 0.05).The guide group obtained an average follow-up of 12.9 months (from 12 to 16 months) while the manual group obtained an average follow-up of 13.2 months (from 12 to 18 months).All fractures healed primarily,without complications like injuries to nerve root or dural sac.Conclusion Our self-designed guide is recommendable because it can obviously improve accuracy of placement of lumbosacral pedicle screws,shorten operation time,and decrease times of intraoperative fluoroscopy.

Objective To investigate the safety of left atrial appendage occlusion by silk thread ligation during open heart op‐eration in patients with rheumatic atrial fibrillation ,and to evaluate its effectiveness for prevention of cerebral embolism .Methods From April 2012 to March 2014 ,129 patients with rheumatic atrial fibrillation were undergone mitral valve replacement and left at‐rial appendage occlusion by ligation using two silk threads from the outside of the heart (ligation group) .The indexes related to the operation ,postoperative complications incidence ,and cerebral embolism incidence during the follow‐up period of ligation group were compared with the indexes of another 129 patients without ligation of left atrial appendage over the same period (control group) . Results The operation time ,the cardiopulmonary bypass time ,the clamp time ,the intensive care unit stay time ,the postoperative hospitalization time in ligation group were (235 ± 50)min ,(88 ± 24)min ,(57 ± 16)min ,(26 .5 ± 9 .3)h and (12 .4 ± 7 .5)d respective‐ly ,and significant difference was not found compared with control group (P>0 .05) .The thoracotomy for hemostasis(1 cases) ,low cardiac output syndrome(2 cases) ,acute renal failure(2 cases) ,pulmonary infection(3 cases) ,sternal wound dehiscence(2 cases) and other complications in ligation group had no significant difference ,compared with control group(P>0 .05);2 cases died in liga‐tion group ,3 patients died in control group ,the differences had no statistical significance(P>0 .05) .No cerebral embolism occurred in ligation group with 127 patients following‐up (23 .6 ± 11 .3) months ,but 5 patients suffered from cerebral embolism in control group with 126 patients following‐up (22 .9 ± 12 .1) months ,the difference had statistical significance(P<0 .05) .Conclusion Left atrial appendage occlusion by silk thread ligation during open heart operation in patients with rheumatic atrial fibrillation is simple and safe ,can reduce cerebral embolism incidence .