Adult ; China ; epidemiology ; Construction Industry ; Female ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; epidemiology ; Ships ; Welding ; Young Adult

Objective To study the early clinical outcome of patients undergone minimally invasive direct coronary bypass(MIDCAB) surgery,and the mid-term patency of left internal mammary artery(LIMA)-left anterior descending(LAD) anastomosis.Methods From Jannuary 2007 to May 2014,47 cases underwent MIDCAB surgery in our department,with 35 males and 12 females,aged 48-76 years,with the average of (62.9 ± 8.1) years old.Types of LAD lesions were as followed:1 case was ostial total obstruction,28 severe stenosis at proximal segment,10 long and severe stenosis,3 calcified lesion with severe stenosis,5 myocardial bridge.All patients had symptomatic angina,typical myocardial ischemia could be detected by electrocardiogram for all patients with myocardial bridge.Comorbidities included:hypertension 38 cases,27 diabetes mellitus,3 COPD and 3 chronic kidney disease.Results All surgery went well without transfer to mid-sternotomy.LIMA harvest time was 38-53 minutes,mean LIMA flow rate was(22 ± 6) ml/min after anastomosis.Surgery duration was 117-143 minutes,blood loss was less than 100 ml for each operation.No blood transfusion was required.Tracheal intubation time was 4-16 hours,ICU stay time was 22-45 hours,hospital stay time was 6-10 days.There was no peri-operative death,either no myocardial infarction or cerebral vessel accident.During follow-up,all LIMA-LAD appeared to be patent by coronary CT angiography.Conclusion High patency rate of LIMA-LAD anastomosis could also be obtained during MIDCAB surgery.It was reserved as a safe and effective surgery for well-selected patients.

Background and purpose:Both nature killer cells(NK)and cytoxic T lymphocytes in the body tissues of human are the dominant components of cellular immunity,This study was done to explore the degree of infiltration of NK/T in lung squamous cell carcinoma and its relation to patient survival and prognosis.Methods: CCD8 as the markers cytoxic T lymphocyte(CTL)and CD56 as the markers natural killer(NK)were stained immunohistochemically to detect the distribution and infiltration in the lung squamous cell carcinoma specimens. Results:In 39 of 68 lung neoplasm,whose CTL infiltration was zero or mild,the five-year survival rate was 18%, while in 29 with marked CTL infiltration,the five-year survival rate was 42%.In 46 of 68 lung neoplasm,whose NK infiltration was zero or mild,the five-year survival rate was 14%,while in 22 with marked NK infiltration,the five-year survival rate was 45%.In 48 of 68 lung neoplasm,both the NK and T cells were zero or mild,the five-year survival rate was 33%,while in 20 with marked NK and T cell infiltration,the five-year survival rate was 54%.The five-year survival difference among the patients with NK,T infiltration either marked or zero/mild infiltration were significant(x~2=18.62, P=0.00).Conclusions:The degree of NK and T infiltration is positively correlated with the prognosis and survival time of lung squamous cell carcinoma patients.

Objective To compare the humoral immunity features of acute glomerulonephritis and nephritic syndrome(NS) in children for earlier differential diagnosis and rational administration.Methods Nephelometry was used to determinate the serum level of immunoglobulin(Ig)G,IgA,IgM,C3,C4 in children by England MININEPH machine and correlated reagent. The serum level of IgE was determined by IgE enzyme linked immunosorbent assay(ELISA),assay ELISA kit of America E&ELABSINC company. Immunoturbidimetry and westergren method were used to detect anti-streptolysin O(ASO) and erythrocyte sedimentation rate(ESR),respectively.Results There were significant diffe-rence features of humoral immunity between acute glomerulonephritis and NS in children.IgG,IgA,IgE,C3,C4 had significant difference between acute glomerulonephritis children and healthy children(Pa

Objective To investigate the clinical spectrum of respiratory viruses in infants and young children with acute lower respiratory infection(ALRI) in Chongqing area from 2003-2007.And to assess the clinical diagnostic value of virus detection in nasopharyngeal secretions(NPS) and serum viral antibody detection for ALRI.Methods Cases of 2 529 specimens of NPS in hospitalized children with ALRI from Apr.2003 to Oct.2007 were taken for detecting 7 common respiratory virus antigens by immunofluorescence assay including respiratory syncytial virus (RSV),adenovirus(ADV),influenza A(IA),influenza B (IB),parainfluenza virus1-3 (PIV1,PIV2,PIV3).Fifty-five thousand eight hundred and eighty-seven samples were tested for ADV-IgM by ELISA.Among those,45 159 cases were further tested for RSV-IgM by ELISA.Results Respiratory virus pathogens were detected in 778 samples out of 2 529(30.76%) including RSV positive in 668 samples (85.86%),PIV3 positive in 75 samples (9.64%),IA positive in 22 samples (2.57%),ADV positive in 15 samples ( 1.93%),only 1 sample ( 0.13%) positive for both PIV1 and RSV. And the positive rate of RSV-IgM was 0.9%-15.2%,and the positive rate for ADV-IgM was about 0.6%-10.6%.RSV infection occured mainly in winter and spring.Conclusions Respiratory virus is the most common pathogen in children with ALRI during the survey period in Chongqing area,especially for RSV infection.The pattern of RSV circulation varied every year with seasonality.It is suggest that this year is peak one for RSV infection from the monthly positive results,especially in Feburary(50%) in 2007.But the infection rate of PIV3,IA,ADV and PIV1 are lower,particularly IB and PIV2 infection have not been seen for the last 5 years.It is fast and accurate to detect RSV antigen and suit to clinical diagnosis by using immunofluorescence assay than other antibody detection.

Objective To summarize the experience of hybrid repair performed in high risk patients with dissection involving the aortic arch.Methods From Sep.2007 to Mar.2015,hybrid repair was performed in 33 high risk patients with dissection involving the aortic arch including acute (n =8),subacute (n =15),or chronic (n =10) cases.Descripitive statistics were computed for continuous and categorical variables.Results There were 22 male and 11 female patients with a mean age of(69 ± 10) years,and ASA Physical Status Ⅲ-Ⅳ.Simultaneous (n =27) and staged (n =5,mean interval 5.0 ± 1.3 days)endovascular repair were performed via femoral artery.The technical success rate was 100％.The average hospital stay was (16 ±6) days.One case died of cerebral infraction.There were two with strokes,one with pneumonia and two with renal failure as complications.Median follow-up was 47 months (3-66 months).There were four deaths with two were related to aortic artery.Endoleak was found in 3 during follow-up.One type Ⅰ endoleak was cured after remedy hybrid repair.Conclusions Hybrid repair performed in patients at high risk with dissection involving the aortic arch is less invasive with favorable medium and long-term outcomes.

Objective To evaluate the outcomes achieved by using left internal mammary artery(LIMA) to radial artery (RA) total arterial composite grafts in minimally invasive direct coronary artery bypass grafting (MIDCAB) for patients with multiple vessel disease.Methods From January 2009 to September 2015, 39 patients(24 males) with multiple vessel disease underwent MIDCAB with LIMA-RA total arterial composite grafts without cardiopulmonary bypass in our hospital .MIDCAB was performed through a left anterior minithoracotomy .Results All patients successfully underwent MIDCAB with LIMA-RA total arterial composite grafts.No patient required to convert to strenotomy during the surgery.Mean operation time was(176.1 ± 14.1)min.Revascularization was performed for 2 target vessels in 11 cases, 3 target vessels in 25 cases and 4 target vessels in 3 cases.Mean postoperative ventilation time was(21.9 ±27.9) h.Mean ICU time was(2.8 ±2.1) days, and mean postoper-ative inhosptial time was(11.2 ±3.3)days.There was no early death in perioperation.At a follow-up of 6 to 86 months[aver-age(27.5 ±18.0) months], one patient died.The overall survival at 2 years postoperatively was(96.0 ±3.9)%.The paten-cy rate of LIMA was 100%.The overall patency rate of RA grafts at 2 years postoperatively was(91.8 ±4.0)%.Conclusion MIDCAB with LIMA-RA total arterial composite grafts is a safe and effective procedure with favorable early and mid-term out-comes for patients with multiple vessel disease .

Objective To sunomanize the experience of consecutive 353 patients and mean 2-years follow-up following Mei mini maze procedure for atrial fibrillation.Methods Between June 2010 and May 2015,353 patients(240 males, 113 females) of atrial fibrillation received this therapy.The age of these patients were(59.7 ± 8.5) years.Among them, 186 were with paroxysmal and 167 were with non-paroxysmal.The procedure, through three ports on left chest wall, included pulmonary vein isolation and ablations of the roof and posterior wall of left atrium which were achieved by bipolar radiofrequency ablation.Ganglionic plexus ablation was made by the ablation pen.Left atrial appendage was excluded.Results Durations of their procedures were(92.3 ± 19.1) mins.No conversion to sternotomy or pacemaker implantation occurred and none of the patients died.The hospital stay was(8.5 ± 2.1) days.The mean follow-up duration was (25.0 ± 15.1) months.308 (90.1％) patients were in sinus rhythm.34 patients could not maintain sinus rhythm.Stroke, thrombus in the left atrium and stenosis of pulmonary vein were not found after their procedures.Conclusion Mei mini maze procedure is a safe, effective, and appropiiate treatment for AF, which restores sinus rhythm and may be associated with the prevention of AF-related stroke.It deserved to be promoted in future.

Objective To investigate the effect of infection on the expression of substance P(SP) and Th1 cytokine on colonic mucosa in patients with irritable bowel syndrome(IBS).Methods Mucosa biopsy samples were obtained in descending colon and rectum from 77 patients(20 post-infective-IBS cases)and 30 controls by colonoscopy.The expressions of SP,interleukin(IL)-2,interferon(IFN)-?were determined by immunohistochemical staining.Results Compared with controls,expressions of SP,IL-2 and IFN-?were significantly increased in IBS patients with diarrhea-predominant(P＜0.05),and expression of SP in post-infective-IBS patients with cytokines positive(IL-2 and IFN-?)were also signifi- cantly increased(P＜0.05).There were no significant differences between non post-infective-IBS and controls.Conclusions Expression of SP was significantly increased in post-infective-IBS.SP upregulated the expression of Thl cytokines(IL-2 and IFN-?).Gastrointestinal infection may involve in the patho- genesis of IBS through neuroimmune mechanism.

Objective Objectives: To introduce the technique of performing minimally invasive concomitant Cox Maze Ⅳ ablation procedure entirely by bipolar clamp through right lateral minithoracotomy for patients with atrial fibrillation(AF) associated with mitral valve diseases.Methods Sixty nine patients with mitral valve disease and long-standing persistent AF received minimally invasive Cox Maze Ⅳ ablation procedure combined with mitral valve surgery from June 2012 to January 2015.The etiology of mitral valve disease was rheumatic(41 cases) and degenerative(28 cases).Age at operation ranged from 52 to 71 years.There were 43 males and 26 females.AF duration ranged from 1.5 years to 13 years.Diameter of the left atrium ranged from 42 to 60 mm.Diameter of the left ventricle ranged from 43 to 66 mm.Left ventricle ejection fraction (LVEF) ranged from 0.45 to 0.67.Concomitant Maze Ⅳ ablation procedure was performed through right lateral minithoracotomy entirely by bipolar radiofrequency clamp.Results All patients successfully underwent this minimally invasive concomitant Maze Ⅳ ablation procedure and mitral valve surgery.The mean cardiopulmonary bypass time was(130.3 ± 17.7) minutes.The mean aortic crossclamp time was(91.8 ± 12.7) minutes.No patient needed conversion to sternotomy during the surgery.There was no early death or pacemaker implantation in the perioperation.The average length of hospital stay was(9.8 ± 3.3) days.At discharge, 65 patients(65/69, 94.2％) maintained sinus rhythm.At a mean follow-up time of(21.0 ± 8.6) months, sinus rhythm was restored in 62 patients(62/69, 89.9％).Cumulative maintenance of normal sinus rhythm without AF recurrence at 2 years postoperatively was(85.1 ± 5.8)％.Conclusion The minimally invasive concomitant Maze Ⅳ ablation procedure performed entirely by bipolar clamp through right lateral minithoracotomy was a safe, feasible, and effective technique for patients with AF associated with mitral valve diseases.