Objective Toinvestigatethepreoperativeriskfactorsofpostoperativeatrialfibrillation(POAF)inpatients undergoingoff-pumpcoronaryarterybypassgrafting(CABG). Methods Atotalof1888patientsunderwentoff-pump CABGinourhospitalweredividedintonewonsetatrialfibrillationgroup(POAFgroup, n=389)andnonAFgroup(NPOAF group, n=1 499). Univariate analysis was used to compare general clinical data, preoperative biochemical indicators, preoperativeechocardiography,coronaryarterydiseaseandpreoperativemedicationbetweentwogroups.Theindicatorswith statisticallysignificantdifferenceswerefurtheranalyzedbyLogisticsregressionanalysis. Results TheincidenceofPOAF was20.60%(389/1888).Thedataofage,chronicobstructivepulmonarydisease(COPD)history,myocardialinfarction history, preoperative urea nitrogen (BUN) level, left atrial diameter (LAD) and left ventricular end diastolic diameter (LVEDD)werehigherinPOAFgroupthanthoseofNPOAFgroup,andthepreoperativeHYHAgradingwaslowerinPOAF groupthanthatofNPOAFgroup（P＜0.05).Theproportionofpreoperativeuseofbetablockerswassignificantlylowerin POAFgroupthanthatofNPOAFgroup(P＜0.01).LogisticregressionanalysisshowedthatincreasedageandLADwere independentpreoperativeriskfactorsforPOAF.PreoperativebetablockerapplicationwasaprotectivefactorforPOAF. Conclusion Itsuggeststhatage,LADandpreoperativebetablockerapplicationarerelatedtotheoccurrenceofPOAFin patientsunderwentoff-pumpCABG.

AIM:To compare the clinical effect of 23G and 25G+ vitrectomy for treatment of proliferative diabetic retinopathy (PDR).METHODS: A total of 128 PDR patients (195 eyes) requiring vitrectomy in our hospital from November 2013 to May 2016 were randomly divided into 25G+ group and 23G group, 64 cases (97 eyes) in 25G+ group and 64 cases (98 eyes) in 23G group.In 25G+ group, patients were treated by 25G+ vitrectomy.In 23G group, patients were treated by 23G vitrectomy.The visual acuity, as well as intraocular pressure (IOP), iatrogenic injury and complications in two groups were recorded before and 1d, 1wk, 1mo after treatment.The operation time was compared between two groups.RESULTS: The operation time in 25G+ group was lower than that in 23G group (P<0.05).The postoperative visual acuity at 1mo of two groups were improved compared with before surgery (P<0.01).However, visual acuity between two groups in the same period had no significant difference (P>0.05).IOP in 25G+ group before surgery had no significant difference compared with those after surgery at 1d,1wk, and 1mo(P>0.05), which it was the same in 23G group.IOP of two groups in the same period had no significant difference (P>0.05).The incidence rate of iatrogenic injury in 25G+ group was 4.1%, which was significant lower than that of 23G group (13.3%) (P<0.05).The incidence rate of complication in 25G+ group was 3.1%, which was significant lower than that of 23G group (11.2%) (P<0.05).CONCLUSION: Both 23G and 25G+ vitrectomy are safe and effective treatment for PDR.However, 25G+ vitrectomy is the better choice for PDR for the shorter operation time, lower incidence rate of iatrogenic injury and fewer surgical complications.

Objective To compare the clinical effects of microneurosurgery by supraorbital key-hole or endonasal transsphenoidal approaches in the treatment of pituitary adenoma and investigate their complications. Methods We retrospectively analyzed the data of 87 patients with pituitary adenoma of which the anteroposterior diameter was less than 3 cm. These patients, admitted to our hospital from May, 2006 to June, 2008, were operated in an endoscope-assisted microsurgical manner via a supraorbital key-hole approach (n=42) or an endonasal transsphenoidal approach (n=45). The efficacy of these two approaches was compared and their complications were observed. Results The excision rate of the pituitary adenoma developing on or around the sella turcica operated through the supraorbital key-hole approach was significantly higher than that through the endonasal transsphenoidal approach(P< 0.05); while that of microadenoma or adenoma developing towards the sphenoid sinus operated through the supraorbital keyhole approach was statistically lower than that through the endonasal transsphenoidal approach (P<0.05). No obvious differences on the improvement of endocrine secretion, visual acuity and field was noted in these two approaches (P>0.05). The incidence rate of epistaxis and unilateral dysosphresia in the supraorbital key-hole approach was significantly lower as compared with that in the endonasal transsphenoidal approach (P<0.05). Conclusion Rarely having such complications as dysosphresia, epistaxis and sphenoiditis, neuroendoscopic surgery through supraorbital key-hole approach is the best way of treating the pituitary adenoma developing on or around the sella turcica and worth to promote in clinic.

Objective To investigate the expression of GOLPH3 in the tumor tissues of patients with gliomas and evaluate its clinical significance. Methods Seventy-six patients with brain gliomas (13 with grade Ⅰ, 27 grade Ⅱ, 25 grade Ⅲ and 11 with glioblastoma) performed surgical excision in our hospitals from July 2008 to December 2009 were chosen and 9 cases of normal brain tissues from patients performed decompression operation resulting from cerebral hernia were selected as the controls in our experiment. RT-PCR and Western-blotting were used to detect the mRNA and protein expressions of GOLPH3. Results The results investigated by RT-PCR and Western-blotting were consistent,revealing that the mRNA and protein expression rate of GOLPH3 in glioma tissues was not significantly different between different grades of tumors (P＞0.05), but their expression value was obviously significant between different grades of tumors and increased in a grade-dependent manner (P＜0.05). And minimal mRNA and protein expressions of GOLPH3 were found in the tissues of controls. The up-regulative protein expression of GOLPH3 was positively correlated to the malignancy-grade of the gliomas (r,=0.961, P=0.000). Conclusion The mRNA and protein expressions of GOLPH3 are noted with positive correlation to the pathological grades of the gliomas, indicating th at GOLPH3 may play an important role in the generation and development of gliomas.

OBJECTIVEThis study examined the distribution and expression of transforming growth factor-ß₂ (TGF-ß₂) in the hip capsule of children with developmental dysplasia (dislocation) of the hip (DDH) and non-DDH children in order to investigate the roles of TGF-ß₂ in hip joint laxity.

METHODSEight children with DDH and eight age- and gender-matched non-DDH children (control group) were enrolled. The immunohistochemical technique (S-P method) was used to examine the distribution and content of TGF-ß₂ in the hip capsule. Semiquantitative RT-PCR method was used to detect mRNA expression of TGF-ß₂ in the hip capsule. The quantitative analysis of TGF-ß₂ was performed by professional image software.

RESULTSA high expression of TGF-ß₂ was observed in the synovial layer with fibroblast regularly arranged parallel to the joint surface. There was decreased expression of TGF-ß₂ in the fibrous layer of the capsule. The percentage of positive fibroblasts and the gray-scale density in the fibrous layer in the DDH group were significantly lower than those in the control group (P < 0.01). TGF-ß₂ mRNA expression in the DDH group decreased compared with that in the control group (P < 0.05).

CONCLUSIONSThe decreased TGF-ß₂ in distribution, content and mRNA expression in the hip capsule might contribute to hip joint laxity in children with DDH.

Child ; Child, Preschool ; Female ; Hip Dislocation, Congenital ; metabolism ; Hip Joint ; chemistry ; Humans ; Immunohistochemistry ; Infant ; Joint Capsule ; chemistry ; Male ; RNA, Messenger ; analysis ; Reverse Transcriptase Polymerase Chain Reaction ; Transforming Growth Factor beta2 ; analysis ; genetics

One of the pathological feathers of Alzheimer's disease (AD) is neurofibrillary tangles (NFTs), which consist of paired helical filaments (PHFs) formed by hyperphosphorylated microtubule-associated protein tau. To study the role of mitogen-activated protein kinase (MAPK) in tau hyperphosphorylation and the underlying mechanism, wild type mouse neuroblastoma cells (N2a) were dealt with different concentrations (0.1 microg/mL, 0.2 microg/mL and 0.4 microg/mL) of anisomycin (an activator of MAPK) for 6 h. The relationship between MAPK activity and tau phosphorylation at some Alzheimer-sites was analyzed, and the activities of protein kinase A (PKA) and glycogen synthase kinase-3 (GSK-3) were detected. The results showed that anisomycin activated MAPK in a dose-dependent manner, but tau hyperphosphorylation at Ser-198/199/202 and Ser-396/404 sites was only observed when the concentration of anisomycin was at the level of 0.4 microg/mL, and the alteration of tau phosphorylation at Ser-214 showed no significant difference in different groups. 0.2 microg/mL and 0.4 microg/mL of anisomycin led to an increase in the activity of GSK-3, respectively, but had no effect on the activity of PKA. Lithium chloride, a specific inhibitor of GSK-3, completely abolished the anisomycin-induced elevation of tau phosphorylation without any effect on the activity of MAPK. In conclusion, overactivation of MAPK up to a certain degree induces tau hyperphosphorylation at Ser-198/199/202 and Ser-396/404 sites, and this is probably related to the effect of activated GSK-3 by MAPK.
Alzheimer Disease ; pathology ; Animals ; Anisomycin ; pharmacology ; Cell Line, Tumor ; Cyclic AMP-Dependent Protein Kinases ; metabolism ; Glycogen Synthase Kinase 3 ; metabolism ; Mice ; Mitogen-Activated Protein Kinases ; metabolism ; Neurofibrillary Tangles ; pathology ; Phosphorylation ; tau Proteins ; metabolism

OBJECTIVETo observe and investigate the risk factors and pathogen diversification of nosocomial lower respiratory infections in patients with hematological malignancy after chemotherapy.

METHODSRespiratory tract microbial population of fifty patients with different kinds of hematological malignancy and para-prepared to chemotherapy was quantitatively analyzed before and after chemotherapy at an arranged time from April, 2004 to December, 2005. Susceptibility test was determined for bacterium of nosocomial infection, and the homology of the same species of the bacteria was analyzed by a pulsed field gel electrophoresis (PFGE).

RESULTSIncidence rate of lower respiratory infections in patients with the hematological malignant after chemotherapy was 16%. The major nosocomial infectious pathogens were Acinetobacter spp; Escherichia coil and Fungus. Among them, Acinetobacter spp, were highly resistant to cephalosporins, quinolones, aminoglycosides, carbapenems and antibiotic with enzyme inhibitor, respectively but susceptible to Cefoperazone/Sulbactam belonging to antibiotic with enzyme inhibitor. And it was shown that there were two clones by the pulsed field gel electrophoresis (PFGE).

CONCLUSIONFollowing-up of nosocomial lower respiratory infection in patients with hematological malignancy after chemotherapy might offer theoretical evidence for the rational use of antibiotics and the control of nosocomial infections.

Acinetobacter baumannii ; drug effects ; isolation & purification ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Cross Infection ; epidemiology ; Escherichia ; drug effects ; isolation & purification ; Female ; Follow-Up Studies ; Hematologic Neoplasms ; drug therapy ; immunology ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Opportunistic Infections ; epidemiology ; Respiratory Tract Infections ; epidemiology

Objective To evaluate the clinical significance of bone scintigraphy in the preoperative diagnosis of sacral tumor. Methods Preoperative 99Tcm-methylene diphosphonate (MDP) whole body bone scintigraphy was performed in total of 103 patients with sacral tumor for whole body survey and radionuclide uptake in the sacral tumor. Of these 103 patients,39 had SPECT. According to the osteoblastic reaction in bone SPECT studies,patterns of tumor with a "hot" lesion was defined as type Ⅰ,a "cold" lesion accompanied with partial uptake was defined as type Ⅱ,a purely "cold" lesion was defined as type Ⅲ,and a "cold" lesion with marginal uptake which produced "doughnut sign" was defined as type Ⅳ. Imaging interpretation was correlated with the final pathologic diagnosis. Results Of the 103 patients,18 ( 17.5% ) had polyostotic involvement. About 46.6% (48/103 ) in planar and 84.6% ( 33/39 ) in SPECT showed decreased uptake at sacrum. Of the bone metastatic patients (n =21 ) ,12 (51.7%) had sole metastasis to sacrum. Tumor with type Ⅰ (6/6) or type Ⅱ (16/19) uptake was likely to be a malignancy,whereas type Ⅲ uptake tended to occur in the benign disease in those patients without polyostotic involvement( 5/7 ),and type Ⅳ was all appeared in giant cell tumors( n = 5 ). Conclusions Preoperative bone scintigraphy is useful in examination of polyostotic involvement for the patients with sacral tumor,but it is limited for diagnosing isolated sacral metastatic disease. Tumor uptake on bone scintigraphy can be helpful in differential diagnosis of sacral tumor.

Objective This study was designed to examine the impact of the antioxidant metallothionein (MT) on cardiac contractile, intracellular Ca2+ function and oxidative stress in lipopolysaccharide (LPS)-treated mice. Methods Weight and age matched adult male FVB and cardiacspecific MT-overexpressing transgenic mice were injected intraperitoneally with 4 mg/kg Escherichia Coli LPS dissolved in sterile saline or an equivalent volume of pathogen-free saline ( control groups). Six hours following LPS or saline injection, cardiac geometry and function were evaluated in anesthetized mice using the 2-D guided M-mode echocardiography. Mechanical and intracellular Ca2+ properties were examined in hearts. Cell shortening and relengthening were assessed using the following indices: peak shortening (PS)-indicative of the amplitude a cell can shorten during contraction; maximal velocities of cell shortening and relengthening ( ± dl/dt) -indicative of peak ventricular contractility; time-to-PS (TPS) -indicative of systolic duration; time-to-90% relengthening ( TR90 )-indicative of diastolic duration ( 90% rather 100%relengthening was used to avoid noisy signal at baseline concentration). The 360 nm excitation scan was repeated at the end of the protocol and qualitative changes in intracellular Ca2+ concentration were inferred from the ratio of fura-2 fluorescence intensity (FFI) at two wavelengths (360/380). Fluorescence decay time was measured as an indicator of the intracellular Ca2+ clearing rate. Glutathione/glutathione disulfide ratio and ROS generation were detected as the markers of oxidative stress. Results Heart rate was increased while EF was reduced in LPS-FVB mice and heart rate was reduced and EF increased in MT-LPS transgenic mice [(528 ±72) beats/min vs (557 ±69) beats/min, (66 ± 14)% vs (42 ± 10)%, P ＜0.05].Cardiomyocytes from the LPS treated FVB mice displayed significantly reduced peak shortening (PS) and maximal velocity of shortening/relengthening ( ± dl/dt ) associated with prolonged time-to-90%relengthening (TR90), these effects were attenuated in cardiomyocytes from the MT-LPS mice [PS (5 ±1.1 )% vs (7.2 ± 0. 8)%, dl/dt (160 ± 15) μm/s vs (212 ± 36) μm/s, - dl/dt (175 ± 32) μm/s vs (208 ±29)μm/s, TR90 (0.24 ±0.03)s vs (0.19 ±0.02) s, P ＜0.05].LPS treated mice showedsignificantly reduced peak intracellular Ca2 + and electrically- stimulated rise in intracellular Ca2 + as well as prolonged intracellular Ca2+ decay rate without affecting the basal intracellular Ca2+ levels, again, these effects were significantly attenuated in MT-LPS transgenic mice. Metallothionein overexpression also ablated oxidative stress [reduced ROS generation and increased glutathione/glutathione disulfide ratio, ROS(0. 35 ±0.08)A/μg protein vs (0.24 ±0.03) A/μg protein] . GSH/GSSG 2.1 ±0.2 vs 2.6 ±0.4, P ＜0. 05. Conclusion MT overexpression improved cardiac function and ablated oxidative stress in LPS treated mice.

Objective To explore the application of parents' presence induction program (PPIP) during anesthesia induction in children in the operation room and the nursing. Methods 86 children patients (1~11 years old) who would accept the operation were randomly divided into the observation and the control group (n=43 in each group). The observation group was accompanied by their parents when the children accepted the anesthesia induction under the instruction of nurses. But the patients were not present in the control group, and the patients were leaded into the operation room directly by the nurses to accept the anesthesia induction. Blood pressure and pulse changes before and after the anesthesia induction of these children patients were observed. The feeling of their heads of family before the operation and the satisfaction about PPIP were investigated. Results Blood pressure and pulses in the control group were significantly higher than those in the observation group before they were leaded into the operation room (P<0.01). 95% of heads of family hoped to accompany their children when they accepted the anesthesia induction, and 93.7% of heads of family wanted to take part in the PPIP. The satisfaction rate about PPIP was 95% after the completion of PPIP. Conclusions There are many profits about PPIP, such as mitigating the fear and anxiety of children and relaxing the unstable feeling of their heads of families before the anesthesia, and reducing the quantity of pre-anesthetic medications. These are helpful to the anesthesia induction and the cooperation of doctor patients. It is a best anesthesia induction mode worthy to be extended in the operation room.