Objective To explore mycocardial protection effect of sevoflurane post-conditioning in off-pump coronary artery bypass grafting (OPCABG) surgery,and the mechanism of mycocardial protection of sevoflurane post-conditioning.Methods Thirty six patients undergoing OPCABG were randomly divided into three groups:at 1.5 MAC (minimum alveolar concentration) for 5 minutes first,with an interruption control group (Cont group),sevoflurane preconditioning group (SPC group),and sevoflurane postconditioning group (SPO group).All patients were administrated by intravenous anesthetic drug,both for induction and maintenance.No special interventions were used in Cont group.However,in SPC group,12 patients inhaled sevoflurane for 10 minutes,then continued for 5 minutes,total 10 minutes before the anastomotic between mammary artery and anterior descending artery.In SPO group,12 patients inhaled sevoflurane at 1.5 MAC for 2 minutes before the anastomosis of last one coronary artery,and continued for 8 minutes.Four time points were focused on including T1 (accomplishment of induction),T2 (1 hour after the coronary revascularization),T3 (6 hour after the coronary revascularization),and T4 (24 hour after the coronary revascularization).Blood samples were drawn from the internal jugular vein for the measurement of the plasma concentrations of TNT-hs (highly sensitive cardiac troponin T),CK-MB (creatine phosphokinase isoenzyme),NT-proBNP (N-Terminal fragment of the prohormone Brain-Type Natri-uretic Peptide),and TNF-α (tumornecrosis factor-α).Results All the patients completed the trials without significant adverse effects.The age,gender,ejection fraction,and operative time among three groups were no statistically significant difference (P ＞ 0.05).Stay time in postoperative ICU and hospital were significantly less than Cont group (P ＜ 0.05).Compared to the pre-operative baseline,all patients'plasma concentrations of TNT-hs,CK-MB,NT-proBNP,and TNF-α were significantly increased at 1 h,6 h,and 24 h after coronary revascularization (P ＜0.05).TNT-hs in Cont group showed a persistent increase,while in other two groups (SPC and SPO),TNT-hs reached the peak concentrations at 6 hours after the coronary revascularization,which were same with CK-MB,TNF-α,and MDA in all groups;NT-proBNP reached the peak at coronary revascularization after 24 h.Compared to Cont group,TNT-hs,CK-MB,and TNF-α in groups SPC and SPO were significantly lower at 6 h,24 h after coronary revascularization; NT-proBNP was significantly lower only at 24 h after coronary revascularization.Conclusions Sevoflurane post-conditioning in OPCABG has identified myocardial protection,which was comparable with sevoflurane preconditioning.

Objective To analyze clinical risk factors for radioiodine(RAI)-refractoriness of DTC with distant metastasis and do survival analysis.Method The clinical data of 77 differentiated thyroid cancer(DTC) patients with distant metastasis admitted to the department of radionuclide therapeutics of Qilu Hospital from Jan 2002 to Sep 2015 were collected to make the retrospective analysis by dividing into radioiodine-refractory(RAI-R) group and radioiodine-efficient(RAI-E) group.Result (1)In DTC patients treated by 131I, there are 77(7.15%) patients with distant metastasis.Among DTC with distant metastasis, 25(32.47%) patients are identified as RAI-R DTC with average age of (56.2±16.0) years old, median age of 57 years old, and male-to female ratio of 1∶2.57.(2)Univariate analysis shows that age of distant metastasis older than 45 years and pathological type of follicular thyroid cancer(FTC) are two risk factors related to RAI-refractoriness.Logistic regression analysis indicates that age of distant metastasis older than 45 years and pathological type of FTC are the independent risk factors for RAI-refractoriness of DTC with distant metastasis.(3)3-year and 5-year survival rates of the 25 RAI-R DTC patients with distant metastasis are 75% and 62%,while RAI-E DTC patients were all alive.The survival of RAI-R DTC with distant metastasis is significantly worse than RAI-E DTC with distant metastasis.Conclusions (1)In the DTC with distant metastasis, the rate of RAI-R DTC is not low, and it is 32.47%.Females of RAI-R DTC are more than males.(2)Age of distant metastasis older than 45 years and pathological type of FTC are independent risk factors for RAI-refractoriness of DTC with distant metastasis.(3)The survival rate of RAI-R DTC with distant metastasis was significantly lower than that of RAI-E DTC with distant metastasis.

Severe acute respiratory syndrome is an infectious disease caused by a new type of coronavirus. It belongs to the seasonal febrile diseases in traditional Chinese medicine. The prevention and treatment of severe acute respiratory syndrome (SARS) can be under the guidance of the doctrines for treating febrile diseases of traditional Chinese medicine, treatment based on syndrome differentiation, such as syndrome differentiation of triple energizer, syndrome differentiation according to defensive phase, qi phase, nutrient phase and blood phase. During April and May of 2003, 8 cases of SARS were diagnosed in Shanghai, and 6 patients accepted complementary therapy of traditional Chinese medicine, without death case. The only one patient who didn't take glucocorticoid therapy was complementarily treated with traditional Chinese herbs through the whole treating procedure. Upon the successful treatment of the eight cases of SARS in Shanghai, it is demonstrated that the triple-energizer syndrome differentiation and defensive-qi-nutrient-blood syndrome differentiation in traditional Chinese medicine are of high value in treating SARS patients.

Objective To screen the proteins with decreased expression in the synovial tissues of rheumatoid arthritis (RA) patients by comparing their expression profiles with that of osteoarthritis (OA) and ankylosing spondylitis (AS) patients by a proteomic approach,and to explore the association of reduced expression with disease susceptibility by a single nucleotide polymorphism (SNP) analysis.Methods Proteins extracted from the synovial membranes (n=10 for each disease) were separated by 2-D electrophoresis.The proteins with significantly decreased expression in the RA samples were subjected to MALDI-TOF-MS.The results were verified using Western blotting.Tag SNPs located in the targeted gene were assessed using the Taqman assay in a cohort of 267 Chinese patients with RA and 160 healthy controls.The genotyping results were confirmed in a large cohort of 389 patients with RA and 371 healthy controls.SPSS 11.5 software package was used for one way ANOVA and Fisher's exact test.Results The expression of vitamin D-binding protein (VDBP) in the synovial membranes from patients with RA was significantly decreased when examined by proteomic approach.This result was confirmed by Western blotting analysis.The rs2282679 was significantly associated with RA (P=0.026 794).This result was confirmed in a large cohort of RA( OR=0.678 639,95％CI 0.54l 113-0.851 118,P=0.000 776).Conclusion Compared with samples from patients with OA and AS,RA patients' synovial tissues have low VDBP expression when examined by the proteomic method.The tag SNP rs2282679 located in VDBP is significantly associated with RA.The decreased expression and the genetic effect of VDBP in RA suggest that a novel pathogenic pathway,in which vitamin D contributes,may be involved in the arthritis process of RA.

Objective To explore the optimal experiment conditions of CCK-8 and MTS for cell proliferation assays in human amniotic epithelial cells and to evaluate the cytotoxicity of these reagents. Methods Human amniotic epithelial cells (hAECs) in logarithm growth stages were prepared in different cell concentrations with DMEM/F12 and 10% FBS. The sensitivity and optimal wavelengths was determined based on the optical density (OD) measured at 450 nm and 492 nm. The optimal time was determined under the conditions of the same cell concentration and defined OD values. HAECs were treated with DMSO, CCK-8 and MTS for 1 h, 2 h, 3 h, and 4 h, respectively. 24 h later, cytotoxicity of the CCK-8 and MTS was evaluated by determination of cell proliferation and Trypan Blue staining. Results The optimal detection wavelength was 450 nm for CCK-8, and 492 nm for MTS. The sensitivity of CCK-8 was slightly lower then that of MTS. The optimal time for incubation hAECs with CCK-8 was 4 h within 1~4 h. The inhibitory on cell proliferation and cytotoxicity of CCK-8 were weaker then those of MTS. Conclusion CCK-8 is a convenient reagent with low cytotoxicity for detection of the proliferation of hAECs.