Objective To review the outcome of coronary artery bypass graft (CABG) using left internal thoracic artery grafts in the patients aged over 70 years old.Methods Two hundred and eighty-eight patients aged over 70 years old from January 2009 to January 2014 who underwent CABG were selected.All of the patients were divided into two groups on base of the graft:control group:only saphenous vein graft was used in 138 cases; observation group:the left internal thoracic artery to the left anterior descending artery was used in 150 cases,which also included total arterial grafting,facilitated by the use of the radial artery,right gastroepiploic artery was operated in 7 cases,beside these artery grafts,saphenous vein graft was used to anastomosis with other vessels.Results Operative mortality was 2.9％ (4/138) in control group and 2.0％ (3/150) in observation group,and there was no significance (P ＞ 0.05).The volume of blood drainage was larger in observation group [(796.2 ± 382.4) ml] than that in control group [(512.8 ± 387.5) ml],and there was significant difference (P ＜ 0.05).At the same time,there was no significant difference in the incidence rate of second thoractomy,malignant arrhythmia,stroke,poor wound healing,and usage of intraaortic balloon counterpulsation between two groups (P ＞ 0.05).Conclusion It does not increase the mortality and incidence of serious complications using the left internal thoracic artery to the left anterior descending artery in the patients aged over 70 years old during CABG.

Objective To investigate the predictive value of epicardial adipose tissue(EAT) thickness for the recurrence of atrial fibrillation (RAF) after concomitant valve replacement and bipolar radiofrequency ablation.Methods From January 2012 to May 2014,156 patients with permanent atrial fibrillation and organic valvular diseases underwent concomitant valve replacement and successful bipolar radiofrequency ablation in the First People's Hospital of Shangqiu.After 1 year of follow-up,the recurrence of AF was analyzed and the correlation factors were analyzed statistically.Results All patients completed a regular follow-up.During a 12-month follow-up period,RAF was observed in 39 patients (25.0％).Echocardiography-derived regional EAT thickness was significantly greater in RAF patients than that in non-RAF patients((6.9±0.6) mm vs.(5.5±0.7) mm,t=4.649,P＜0.05).The EAT thickness strongly correlated with patients age,body mass index,Ratio of left atrial diameter,mitral diastolic blood flow velocity and early diastolic velocity of mitral annulus,low density lipoprotein-cholesterol and thyroglobulin (r =0.62,0.57,0.68,0.59,0.73,0.76;P ＜ 0.05).Cox multivariable analysis showed that,duration of AF history (95％CI:1.01-1.15,P =0.040),left atrial diameter (95％CI:1.07-1.24,P =0.021) and EAT thickness (95％CI:1.05-1.79,P =0.009) were independent predictors of RAF.Conclusion Echocardiography-derived regional EAT thickness combined with left atrial diameter may serve as effective parameters in identifying patients at the highest risk for RAF.

Objective: To evaluate the effects of PD145065(non-selective endothelin(ET)receptor antagonist)on injured spinal cord and explore mechanisms of how ET plays a role in secondary injury following spinal cord injury(SCI).Methods:Spinal cord of rat was traumatized by compression(50g,1min).PD145065 or vehicle was administered intrathecally 10 minutes before SCI.Alterations of spinal cord blood flow(SCBF),molondialdehyde(MDA),the total content of intracellular calcium(［Ca2+］i),Evans blue(EB),and water in spinal cord were inspected.Results:SCBF of injured area decreased obviously 5 minutes after SCI.SCBF was 75.23±9.21% of baseline 5 minutes after SCI,57.06±7.35% 2 hours.SCBF of adjacent area decreased lower.SCBF was 79.82±7.98% of baseline 30 minutes after SCI.SCBF of injured and adjacent areas did not recover 4 hours after SCI.The contents of MDA,［Ca2+］i,EB and water in traumatized spinal cord were significantly more than that of sham(P＜0.05)。PD145065 ameliorated SCBF of injured area obviously and abolished the decrease of SCBF of adjacent area.The contents of MDA,［Ca2+］i,EB and water in spinal cord of PD145065 treated group were significantly less than that of saline treated group(P＜0.05).Conclusion:PD145065 has protective effects on traumatized spinal cord in early phase.ET and its receptors may play a role in secondary injury following SCI by multiple pathways.ETA/ETB receptor antagonist may be useful in treatment of clinical SCI.

Objective To investigate physical activity in patients with type 2 diabetes mellitus and to analyze its influencing factors,in order to provide references for the prevention and control of disease.Methods A total of 469 cases of patients with type 2 diabetes mellitus were enrolled in this study.The basic information,such as gender,age and so on,and situation of physical activity,including work,housework,transportation and entertainment,were surveyed via questionnaire.Results The total amount of physical activity of patients with type 2 diabetes mellitus in this survey was (1 581.59±743.65)MET-min per week,were mainly contributed from entertainment and housework which was (940.83 ± 547.06) and (407.20 ± 226.63)MET-min per week respectively.The amount of physical activity of patients in different age,occupation,duration of illness and BMI,and patients with or without other chronic diseases were significantly different (P＜0.05).Under 45 years old,being on-the-job,with other chronic disease were risk factors for lack of physical activity in patients with type 2 diabetes mellitus (P＜0.05),while aged 45-＜60 years old,light or normal weight was the protection factors of sufficient physical activity in patients with type 2 diabetes mellitus (P＜0.05).Condusion The overall physical activity of patients with type 2 diabetes mellitus is on the medium level,and its main types are entertainment and housework.Patients under 45 years old,being on-the-job,with other chronic diseases have higher risk of lacking physical activity.

Objective To investigate the clinical effect and safety of Chinese medicinal liniment pourmask and smearing in the treatment of acne. Methods Two-hundred and nine cases of acne were divided into two groups: treatment group (106 cases) was treated with Chinese medicinal liniment pourmask and smearing for 1 to 4 weeks, and control group was treated with gypsum fibrosum pourmask combining chloramphenicol and salicyic acid tincture for 1 to 4 weeks. Results At 8th week the cure rate, effective rate and improved rate in the treatment group and control group were 70.75 %, 29.25 %, 0 % and 34.95 %, 42.72 %, and 22.33 % respectively. Side effects were not found in the treatment group. Ten cases (9.71 %) in control group had contact dermatitis. Conclusion Chinese medicinal liniment pourmask and smearing have a good efficacy and safety in the treatment of acne.

As a commonly used non-contact flatness detection method, laser triangular detection method is designed with low cost, but it cannot avoid measurement errors caused by strip steel vibration effectively. This paper puts forward a dynamic flatness image processing method based on improved laser triangular detection method. According to the practical application of strip steel straightening, it completes the image pre-processing, image feature curve extraction and calculation of flatness elongation using digital image processing technology. Finally it eliminates elongation measurement errors caused by the vibration.

Brain natriuretic peptide(BNP) is a recently discovered novel neuropeptide of 26 amino acid residues, isolated from porcine brain, that is of similar potency to atrial natriuretic factor(ANF) in natriuretic, diuretic, hypotensive and smooth muscle relaxant activities. we used a highly selective antisera against BNP raised in rabbit to observe its distribution and localization in some brain areas and some other peripheral tissues by utili zing high sensitive avidin-biotin-peroxidase complex technique. Positive brain natriuretic peptide immunoreactive (BNPir) fibers and cell bodies were observed in the lateral hypothalamic area, caudate-putamen, hippocampus, amygdala, and supraoptic and paraventricular nuclei. A lot of BNPir granules were also found in rat atria. They were of similar localization to that of ANF. Most of the specific granules were accumulated in cytoplasm at both nuclear poles of atrial myocytes. The BNP immunoreactivity is less intense than that of the ANF. Some of scanty, diffuse and fine BNPir granules could also be observed in ventricular myocytes.The coexistence of both BNP and ANF in the brain and heart indicates that BNP may function as a neuropeptide and circulating hormone, and suggests the possibility that the physiological effects such as diuretic natriuretic, hypotensive and smooth muscle relaxant activities so far thought to be mediated by ANF may be regulated through a dual mechanism involving both BNP and ANF. In addition, some BNPir positive cells were also present in the anterior and intermediate lobes of rat pituitary gland. The significance of BNP in hypophysis would be elucidated in the further studies.

Objective To explore the selection of palliate operation styles for unresectable malignant obstructive jaundice diseases. Methods The clinical data of 112 cases of unresectable malignant obstructive jaundice diseases in the last 5 years were analyzed retrospectively. Results The rate of operation mortality was 7.1％ and the incidence rate of post-operative cholangitis was 17.3 ％.The survival time in the Roux-en-Y choledochojejunostomy group was (9.4±1.6) months, and there were no significant differences among laparotomy stent internal drainage group[(9.8±12.5)months]and the PTCD stent internal drainage group [(9.0± 3.1)months]. But survival time in the laparotomy bridge internal drainage group [(6.8±1.7)months]was significantly lower (P＜0.05). The survival times in the ERCP stent drainage group [(3.5±2.2)months]and exploratory laparotomy group [(2.8±2.7)months]were even more significantly lower (P＜0.01).Conclusion As a palliative operation for unresectable malignant obstructive jaundice diseases, Roux-en-Y choledochojejunostomy applies to the middle and distal obstruction,laparotomy stent internal drainage applies to hilar obstruction,ERCP stent drainage only applies to distal obstruction,and PTCD stent internal drainage applies to any part obstruction of the bile duct. The Roux-en-Y choledochojejunostomy, laparotomy stent internal drainage, and PTCD stent internal drainage would improve the life time and life quality of these patients.

Objective To examine the relationship of body mass index (BMI) with levels of vitamin D,parathyroid hormone (PTH),and bone turnover markers among women in Shanghai area.Methods Altogether 810 Chinese women aged 45 year and older were enrolled to study the associations by multiple linear regression analyses.Bone mineral density was measured by a dual energy X-ray absorptiometry (Lunar,Prodigy,GE),Serum 25-hydroxyvitamin D [25 (OH) D],PTH,C-telopeptide of type Ⅰ collagen (CTX),osteocalcin (BGP),and bonespecific alkaline phosphatase (BSALP) were measured.Results (1) 25 (OH) D,BGP,BSALP,and CTX levels were significantly lower in obesity group than in control group ; PTH level was significantly higher in obesity group than in control group.(2) In multiple linear regression analyses,BMI was significantly associated with lower 25 (OH) D (β =-0.017,P =0.006),BGP (β =-0.077,P =0.019),and higher PTH (β =0.025,P =0.000).Conclusions (1) There were siginificant associations between higher BMI and lower 25 (OH) D among women in Shanghai.(2) Serum osteocalcin was associated not only with bone metabolism but also with energy metabolism.

〔Abstract〕 Based on elaborating the application of WeChat public platform in various industries, the paper overviews the function and characteristics of WeChat public platform, taking Shanxi Provincial Peoplel's Hospital as an example, it introduces the application of We-Chat public platform in outpatient and inpatient departments, points out that WeChat service could be carried out in hospital in the futrue.