OBJECTIVETo study the influence of anastomoses sequence on the hemodynamics in off-pump coronary artery bypass grafting (CABG), and to investigate the strategy to stabilize the hemodynamics.

METHODSFrom March 2005 to March 2007, 67 patients with serious triple-vessel coronary artery lesions (male 45, female 22) with a age range from 44 to 81-years-old were enrolled for off-pump CABG. All the patients underwent left internal mammary artery-left anterior descending branch (LIMA-LAD) anastomose firstly, followed by the foreword anastomose of the other two vessels. According to the anastomose sequence of posterior descending branch (PDA) and obtuse marginal branch (OM), the patients were divided into three groups. Group I (n = 22) did the sequence of PDA-OM-aortic root (Ao). Group II (n = 14) did the sequence of Ao-PDA-OM. Group III (n = 31) did the sequence of Ao-OM-PDA. The hemodynamics markers, including heart rate (HR), central venous pressure (CVP), mean artery pressure (MAP), cardiac index (CI), left ventricular-stroke work index (LVSWI) and right ventricular stroke work index (RVSWI), were analyzed before LIMA-LAD anastomose to serve as baseline. And these markers were re-measured at LIMA-LAD anastomose, immediately after LIMA-LAD anastomose, at PDA anastomose and at OM anastomose.

RESULTSAll the patients survived after off-pump CABG. Compared with the baseline, there were no significant hemodynamic changes when doing LIMA-LAD anastomose. When the anastomose finished, the hemodynamic indices improved significantly. When performing OM anastomose, HR and CVP increased significantly, and MAP, CI, LVSWI and RVSWI decreased remarkably in group I and group III, while there were no significant changes of MAP, CI and RVSWI in group II . When performing PDA anastomose, HR and CVP increased significantly, and MAP, CI, LVSWI and RVSWI decreased remarkably in group I and group II, while there were no significant hemodynamic changes in group III except HR.

CONCLUSIONProximal anastomose first when performing off-pump CABG, followed by distal anastomoses of target vessels is beneficial to those who have hard exposure and difficult anastomose of OM and PDA.

Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical ; methods ; Coronary Artery Bypass, Off-Pump ; methods ; Coronary Artery Disease ; physiopathology ; surgery ; Coronary Vessels ; surgery ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Monitoring, Intraoperative ; Retrospective Studies

Objective:By observing the changes of hyperthermia on serum carbohydrate antigen 125(CA125),human epididymal protein 4(HE4),chitinase protein(YKL) and immune function index effects,to investigate its effect on cancerous ascites and its antitumor effect of cytoreductive surgery combined with intraperitoneal hyperthermic perfusion chemotherapy and in elderly patients with advanced ovarian cancer.Methods: A total of 72 elderly patients with advanced ovarian cancer were enrolled in the study.They were randomly divided into contrast treatment group and combined treatment group,36 cases in each group.The patients in contrast treatment group were treated with cytoreductive surgery combined with intraperitoneal hyperthermic perfusion chemotherapy.The combined treatment group was treated with partial radiofrequency hyperthermia on the basis of the treatment of the control group.The efficacy was evaluated after 2 courses.The changes of CA125,HE4 and YKL contents and T cell subsets were compared between the two groups before and after treatment,and the safety was evaluated.Results: There was no difference in the operation between the two groups.The total effective rate was 80.0% in combined treatment group,which was significantly better than 55.6% in contrast treatment group(χ2=5.175,P<0.01).The effective rate of ascites control was 80.6% in combined treatment group,which was significantly higher than that in contrast treatment group 52.4%(χ2=3.962,P<0.05).After treatment,the levels of CA125,HE4 and YKL in the two groups were significantly lower than those before treatment,and the decrease of the combined treatment group was more significant than contrast treatment group(P<0.05).After treatment,the levels of CD3+,CD4+,CD4+/CD8+in both groups were lower than those before treatment,CD8+was lower than that before treatment,and the improvement of the indexes in combined treatment group was more significant than contrast treatment group(P<0.05).There was no significant difference between the two groups in the adverse effects of bone marrow suppression,gastrointestinal reaction and liver and kidney dysfunction(P> 0.05).Conclusion: CRS combined with IPHC and hyperthermia can significantly improve the immunosuppression of ovarian cancer,reduce the level of CA125,HE4,YKL, improve clinical efficacy of elderly patients with advanced ovarian cancer.

OBJECTIVETo observe the effect of Qubi Recipe (QR) on the expression of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and hypoxia-inducible factor (HIF)-1alpha in rats with type II collagen-I induced arthritis (CIA), and to explore its therapeutic roles and mechanism.

METHODSTotally 72 male SD rats of SPF grade were recruited. Twelve were randomly selected as the blank control group. The CIA model was established in the rest 60 rats by subcutaneously injecting type II collagen of bovine emulsion from the tail root and induction of incomplete Freund's adjuvant. On day 15 after primary immunization rats were randomly divided into four groups, i.e., the CIA model group, the Tripterygium Glycosides (TG) group (at the daily dose of 9.68 mg/kg body weight), the high dose QR group (at the daily dose of 6.66 g/kg body weight), and the low dose QR group (at the daily dose of 3.33 g/kg body weight), 15 in each group. Corresponding medication was given to rats in all groups by gastrogavage once daily for 4 successive weeks. An equal volume of pure water was given to rats in the blank control group and the CIA model group by gastrogavage, once daily for 4 successive weeks. The swelling degree of the joints was measured. Rats were sacrificed after 4-week treatment. Plasma levels of SOD, MDA, and GSH-Px were measured with colorimetric method. The expression of HIF-1alpha was detected by immunohistochemistry.

RESULTS(1) Compared with the CIA model group, the swelling degree of the joints was significantly alleviated in the TG group and the high dose QR group (P < 0.01, P < 0.05), and it was obviously milder in the high dose QR group than in the TG group (P < 0.05). (2) Compared with the CIA model group, the activities of GSH-Px could be obviously elevated and activities of MDA lowered in the TG group, the high dose QR group, and the low dose QR group (P < 0.05). Plasma activities of SOD could be obviously elevated in the high dose QR group and the TG group (P < 0.05). (3) Compared with the CIA model group, the expression of HIF-1alpha obviously decreased in the TG group and the high dose QR group (P < 0.05), and it showed a decreasing tendency in the low dose QR group with no statistical difference (P > 0.05).

CONCLUSIONSQR could markedly alleviate the swelling degree of ankle joints in CIA model rats. Its therapeutic efficacy was superior to that of TG. Its mechanism might be achieved through down-regulating expression of HIF-1alpha in the joint, and regulating activities of SOD, MDA and GSH-Px in the plasma.

Animals ; Arthritis, Experimental ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Glutathione Peroxidase ; blood ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Joints ; metabolism ; pathology ; Male ; Malondialdehyde ; blood ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; metabolism ; Superoxide Dismutase ; blood

Objective To clinically study the antiviral effects of lamivudine and entecavir on patients with early-to-mid stage Hepatitis B related acute on chronic liver failure(HBV-ACLF).Methods A prospective,randomized,open and parallel controlled clinical trial was designed to observe the antiviral effects of nucleoside analogues on patients with early-to-mid stage HBV-ACLF.Three groups were set for controlled study,i.e.basic treatment group,lamivudine plus basic treatment group and entecavir plus basic treatment group.Results One month after treatment,the improvement rates of lamivudine group and entecavir group were 58.85% and 59.15% respectively,significantly hisher than that of basic treatment group which was 34.84%(X2=9.8323,P=0.043).By the end of six months,the cumulative survival rates of patients with the antiviral treatments,i.e.,lamivudine,entecavir,were 65.8%,60.1%,significantly higher than that(42%) without the antiviral treatment(P=0.045,P=0.04 respectively).The cumulative survival rate in patients with a MELD score <30 was higher than that with a MELD score over 30(X2= 3.920 P=0.048).For the patients with pretreatment HBV DNA≥107,the cumulative survival rate in patients with entecavir treatments group was higher than that of patients in basic treatment group(X2=5.014 P=0.025).According to the Ordinal Regression analysis,antiviral therapy by using either lamivudine or entecavia could significantly increase the improvement rate of patients with early-to-mid stage HBV-ACLF. But severe complications, including hepatorenal syndrome, electrolyte imbalance and hepatic encephalopathy,medical history of liver cirrhosis,and pretreatment HBV DNA≥107 had significant impacts on prognosis of this group patients.Conclusions Antiviral therapy by using either lamivudine or entecavia could significantly increase the survival rate of patients with early-to-mid stage HBV-ACLF.

Objective To explore the application of autoregressive integrated moving average (ARIMA) model in peripherally inserted central catheter (PICC) nursing outpatient amount and to study its regularity for forecast.Methods PICC nursing outpatient amount in our hospital from January 2008 to December 2012 was chosen as the study object.ARIMA model was built by stationary sequence,model identification,parameter estimate and model diagnosis to fit and forecast.Results PICC nursing outpatient amount had characteristics of long-term growth trend and seasonality.ARIMA (1,1,1) (0,1,1) 12 model had good fitness to the PICC nursing outpatient amount with autoregressive coefficient (AR1 =0.314),moving average coefficient (MA1 =0.996),seasonal moving average coefficient (SMA1 =0.399) and constant term (C =0.004),all of which were statistically significant (P ＜ 0.05).Goodness of fit R2 =0.787,Box-Ljung =8.117 (P =0.919),and predicting error was white noise.It was predicted that outpatient amount in 2013 would continue to increase steadily.Conclusions ARIMA model is suitable for hunting variation of PICC nursing outpatient amount and grasping the future trend.Application of autoregressive integrated moving average (ARIMA) model will provide not only reference for hospital administrators to learn about variations,but also a new way to predict the future development of PICC nursing outpatient.

Adrenergic receptor (AR), one of the key receptors for nervous system, plays an important role in the immune microenvironment and the progression of many diseases. In recent years, the regulation of ARs and its signal on macrophages has become a research hotspot. Researchers found that ARs could exert different regulatory functions on macrophages in different microenvironments, which in turn affects occurrence and development of diseases such as tumor, heart failure, obesity, acute injury, infection and pregnancy-related diseases. This review summarizes the expression and functional regulation of ARs on macrophages, and the role of ARs in microenvironment of related diseases, which might provide new ideas for the treatments.
Disease ; Humans ; Macrophages ; physiology ; Receptors, Adrenergic ; physiology ; Signal Transduction

Objective:To investigate the molecular mechanism of Buyang Huanwu Tang in improving cerebral vasospasm after subarachnoid hemorrhage. Method:Eighty male Sprague-Dawley rats were randomly divided into sham operation group, model group, Buyang Huanwu Tang low and high dose (13, 26 g·kg^-1·d^-1) group. According to 10 mL·kg^-1, the drug was administered twice a day for 7 days. The subarachnoid hemorrhage model was made by double occipital pool injection method. The neurological function scores of rats in each group were evaluated at 1, 3, 5 and 7 days. The diameter of basilar artery was measured by hematoxylin-eosin (HE)staining. The expressions of phosphp-phosphoinositide 3-kinases(p-PI3K), phosphp-protein kinase B(p-Akt),endothelial nitric oxide synthase(eNOS) and neuronal nitric oxide synthase(nNOS) protein in basilar artery brain tissue were detected by Western blot. The expression of nitric oxide(NO) and endothelin-1(ET-1) in rat cerebrospinal fluid was detected by enzyme-linked immunosorbent assay (ELISA). Result:Compared with sham operation group, the neurological function scores of the model group were significantly decreased (P<0.05), the diameter of the basilar artery was significantly reduced (P<0.05), and The expression of p-PI3K, p-Akt, eNOS, nNOS proteins of the basilar artery brain tissue were significantly decreased (P<0.05). The level of NO in the cerebrospinal fluid was significantly decreased (P<0.05), and the ET-1 was significantly increased (P<0.05).Compared with model group, the different doses in Buyang Huanwu Tang group (26,13 g·kg^-1·d^-1) increased the neurological function scores 3 to 5 days after treatment, and the basilar artery diameter was significant increased (P<0.05).The expression of p-PI3K, p-Akt and eNOS protein was significantly increased (P<0.05).The level of NO was significantly increased (P<0.05), and ET-1 was significantly decreased (P<0.05). Compared with low-dose group, the neurological scores of high-dose group were significantly increased after 7 days of treatment with Buyang Huanwu Tang (P<0.05), and the diameter of the basilar artery was significantly increased (P<0.05), p-PI3K, The expression of p-Akt and eNOS protein was higher (P<0.05), the increase of NO was more obvious (P<0.05), the decrease of ET-1 was more significant (P<0.05). Conclusion:The protective effect of Buyang Huanwu Tang on cerebral vasospasm after subarachnoid hemorrhage may be related to up-regulation of p-PI3K, p-Akt and eNOS expression in PI3K/Akt/eNOS signaling pathway, thereby increasing NO production.

【Objective】This study aimed to explore copy number variations（CNV）in fetuses with conotruncal heart defect （CTD）. 【Methods】 Fetuses with ascertained CTD were investigated for chromosomal aberrations including copy number variations with chromosomal microarray analysis（CMA）and QF-PCR. Based on clinical significance of CNV，Fetuses were divided into two subgroups：non- benign CNV group ［（pathogenic CNV and CNV of unknown significance（VOUS）］and benign CNV group. Data on fetal structural malformations，copy number variations，and pregnancy out? comes were collected and compared.【Results】Among 128 cases without chromosomal aneuploidies ，pathogenic CNV ， CNV of VOUS ，and benign CNV were identified in 5.5% ，4.7% ，and 3.9% ，respectively. Compared with cases in benign CNV group（n=115），fetuses in non- benign CNV（n=13）had a significantly higher rate of overall extra- cardiac anomalies（76.9% vs. 43.5%，P=0.037），structural extra-cardiac anomalies（61.5% vs. 24.2%，P=0.022），softer mark? er anomalies（61.5% vs. 20.9% ，P=0.004），and thymus anomalies（30.8% vs. 0.87% ，P=0.000），whereas，no significant difference in that of intra- cardiovascular anomalies was noted（53.9% vs. 53.9%，P=1.000）excepted for that of persistent left superior vena cava（46.2% vs. 13.9% ，P=0.010）. The incidence of natural death in non- benign group was higher than but not statistically different from that of benign group.【Conclusions】Pathogenic CNV contributed to the pathogenesis of CTD. The presence of associated extra-cardiac anomalies including thymus abnormalities correlated with a higher probability of non-benign CNV.

This study was aimed to investigate the effects of blockade of Ca(2+) activated channel KCa3.1 and voltage-gated potassium channel Kv1.3 of the monocytes/macrophages on inflammatory monocyte chemotaxis. Chemotaxis assay was used to test the inflammatory Ly-6C(hi) monocyte chemotaxis caused by the monocytes/macrophages. The proliferation of monocytes/macrophages was detected by cell counting kit-8 (CCK8). Enzyme-linked immunosorbent assay (ELISA) was applied to detect the C-C motif ligand 7 (CCL7) in cultured media. The results showed that the recruitment of Ly-6C(hi) monocyte induced by monocytes/macrophages was suppressed by the potent Kv1.3 blocker Stichodactyla helianthus neurotoxin (ShK) or the specific KCa3.1 inhibitor TRAM-34. Meanwhile, the proliferation of monocytes/macrophages was significantly inhibited by ShK. The response of Ly-6C(hi) monocyte pretreated with ShK or TRAM-34 to CCL2 was declined. These results suggest that KCa3.1 and Kv1.3 may play an important role in monocytes/macrophages' proliferation and migration.
Cell Movement ; Cell Proliferation ; Cnidarian Venoms ; pharmacology ; Enzyme-Linked Immunosorbent Assay ; Humans ; Kv1.3 Potassium Channel ; antagonists & inhibitors ; physiology ; Macrophages ; cytology ; Monocytes ; cytology ; Protein Structure, Tertiary ; Pyrazoles ; pharmacology ; Small-Conductance Calcium-Activated Potassium Channels ; antagonists & inhibitors ; physiology

Objective:To explore the effect of aerobic exercise on behavioral function in rats with cerebral small vessel disease and its mechanism. Methods:Eight-week-old male Sprague-Dawley rats were randomly divided into sham group (n = 16), model group (n = 16) and swimming group (n = 16). The model was developed with bilateral common carotid artery ligation. They were assessed with burrowing test after four weeks of swimming exercise. The levels of brain-derived neurotrophic factor (BDNF) and tropomyosin receptor kinase B (TrkB) protein in hippocampus were detected with Western blotting. The development of dendrites and synaptic spines in hippocampal neurons was observed with Golgi staining. The expression of Ki67, doublecortin (DCX) and Neun in hippocampal dentate gyrus was detected with immunofluorescence. Results:Compared with the model group, the burrowing ability improved in the swimming group (P < 0.05), with increase of levels of BDNF and TrkB in hippocampus (P < 0.05), Ki67/DCX and Neun positive cells in hippocampal dentate gyrus (P < 0.05), and extension of dendrites and length of synaptic spine in hippocampal neurons (P < 0.05). Conclusion:Aerobic exercise may promote the proliferation and differentiation of hippocampal neurons through BDNF/TrkB signaling pathway, expression of Ki67/DCX and Neun and development of hippocampal neurons, to improve behavioral function in rats with cerebral small vessel disease.