Objective: To summarize and analyze the early outcomes and clinical experience in 1198 patients undergone off-pump coronary artery bypass (OPCAB). Methods: This multi-center report covers 15 different institutes in China from October 1996 to May 2002. The ratio of OPCAB to conventional coronary artery bypass grafting (cCABG) was 85.2%. The mean age was (61.6?9.0) years. 77.3% patients were male and 22.7% were female. There were 34.6% patients with myocardial infarction, 58.2% with unstable angina pectoris, 18.7% with left main lesion, 76.9% with triple-vessel disease, 1.5% was redo surgery, and 9.9% emergent or urgent surgery. The mean left ventricular ejection fraction was 0.56?0.17. Results: The number of distal anastomosis was 3.1?0.9. IMA was used in 65.6% patients and radial artery was used in 18.0%. 13.5% OPCAB was combined with TMLR. IABP was used in 5.2% patients. The hospital mortality was 1.2%. The morbidity included 0.4% peri-operative myocardial infarction, 0.3% heart failure, 1.2% fatal arrhythmia, 2.0% pulmonary complications, 1.2% neurotic disorder, 0.7% renal dysfunction, 1.0% reopen for bleeding, and 0.6% delayed wound healing. Conclusion: OPCAB surgery is a safe and feasible procedure with good early results. Its late outcomes need further follow-up. OPCAB requires certain special skills and methods in practice so a specific training course should be designed.

Objective To investigate expression changes of Tau protein in retinal ganglion cells (RGCs) and oligodendrocytes (Ols) after stretch injury in rats and explore the relationship of Tau protein with pathological changes after axonal injury. Methods Morphological changes of optic nerves, RGCs and OLs after stretch injury were examined under light microscope in control group, stretch only group, heat stress only group and heat stress pretreatment plus stretch group. The expressions of Tau protein in RGCs and OLs after heat stress and/or stretch injury were observed by using immunohistechemical stai-ning. Results Pathological changes of axons, RGCs and OLs were identified morphologically or quan-titatively after stretch injury to the optic nerves, which was significantly ameliorated through pretreatment with heat stress plus stretch injury. The expressions of Tau protein in RGCs and OLs were increased in stretch only group. There was no significant expression change of Tau protein in heat stress only group. Expression of Tan protein was obviously decreased in heat stress pretreatment plus stretch group. Con-clusions Both neurons and glial cells are involved in pathological process after axonal injury. The ex-pression changes of Tau protein are probably related to delayed axotomy and neuron apoptosis. Heat stress can relieve the impairment of cystoskeleton through decreasing and delaying the expression of Tau protein.

Objective:To introduce a new style of platysma myocutaneous flap and to evaluate its application value in the restoration of oral-maxiofacial defects.Methods:Platysma myocutaneous flap with apron incision was used for the restoration of oral-maxiofacial defects after oral lesion ablation in 15 cases from January,2014 to September,2015.The platysma muocutaneous flap was harvested with a U shaped apron incision.The skin above the flap pedicle was preserved.The platysma pedicle was widened to ensure the flap survival.All the patients were followed up form 4 to 33 months.Results:Of the 15 platysma myocutaneous flaps,12 survived completely and 3 had partial flap necrosis.The total survival rate of the flaps at the recipient site of buccal mucosa,tongue and alveolar was 8/9,1/3 and 3/3 respectively.Additionally,there were 2 cases of disturbed wound healing in the neck.Except for 1 case of carcinoma of gingiva which had apparent cervical scar and 1 case of tongue carcinoma which had limited tongue mobility,the other cases showed a satisfactory recovery of oral-maxillofacial contour and fucnction.Conclusion:Compared with the traditional platysma myocutaneous flap,the platysma myocutaneous flap with apron incision can provide a larger skin paddle,and is suitable for the restoration of small and medium sized buccal mucosa and alveloar defects,but not for tongue defect.

Objective To investigate the role of the QQ group follow up of nursing education on patients with nasopharyngeal carcinoma after radiotherapy in patients after they discharged. Methods Thirty patients with nasopharyngeal carcinoma hospitalized from January to December 2013 in our department were set as control group and another 30 patients with NPC hospitalized from January to December 2014 in our department were assined to in the experiment group. Patients of two group received health education before discharge . The controls were followed up on phone and the experimental group received QQ group follow up of education for one year, besides phone follow-up. The two groups were compared in terms of incidence of adverse reactions one year after discharge. Results One year after discharge , the incidences of side effects in the experiment group were lowered than those in the control group , and the differences were siguificant difference ( all P < 0 . 05 ) . Conclusion The QQ group follow up of nursing education can reduce the incidence of adverse reactions by radiotherapy after discharge.

Objective Total aortic arch replacement and stented elephant trunk surgery is an important surgical method for acute type A aortic dissection, and the short, middle, long term curative effect has been recognized by more and more experts at home and abroad.Circulatory arrest was an independent risk factor for postoperative complications and mortality in patients with type A aortic dissection.The aim of this article is to observed the effection of a new technology to block aortic arch, whicn can shorten the circulatory arrest time to 2 minutes and avoid harm of circulatory arrest on patients.Methods From May 2016 to February 2017, 68 patients with acute type A aortic dissection were divided into the conventional group and the modified group.All the patients underwent total arch replacement and stented elephant trunk surgery.The rectal temperature of the conventional group was 25℃ and circulatory arrest time was 20 min.While the rectal temperature of the modified group was 28℃ and and circulatory arrest time was 2 min.Results In the conventional operation group, 3 patients died after operation while all the patients in the modified group were cured and discharged.There are no differences between the two groups in the time of cardiopulmonary bypass(CPB) and heart arrest time(P>0.05).There are Significant differences in CPB time, circulatory arrest time, postoperative awake time, intubation time, amount of blood used, the amount of drainage during the first two days after operation, the time staying in ICU and the postoperative time in hospital.And the modified group was much better.(P<0.05)Conclusion The results of new technology blocking aortic arch in the patients with acute type A aortic dissection are better than the conventional surgical approach during the perioperative period.This technology is simple and effective.It is worth promoting.

Objective To study the differentiation and proliferation ability of the spinal neural stem cells (NSCs) at different gestational ages in fetal rats. Methods Sprague-Dawley fetal rats were divided into group A (12 days of pregnancy), group B (14 days of pregnancy) and group C (16 days of pregnancy). NSCs were separated with enzyme-assisted microdissection. The diameter and numbers of NSCs balls were measured at different time. The cell growth curve was drawn with CCK8 colorimeter. NSCs were identified with BrdU/Nestin immunohistochemical staining. They were induced with 10% fetal bovine serum for 10 days, and the expression of β-tubulinⅢ and glial fibrillary acidic protein was detected with immunocytochemistry. Results There were cells expressed BrdU, Nestin, β-tubulinⅢ and GFAP in all the group. The most cells (22.74±0.79%) expressed β-tubulinⅢ in the group B, but no significant difference between group B and group C. The cell vitality on the 5th day of third-generation neural stem cells was the most in group B. Conclusion For enzyme-assisted microdissection, it may obtain more neurons to isolate the neural stem cells from 14 days of pregnancy pregnant rats.

Objective The aim of this study is to evaluate the efficacy and safety of preoperative Computed Tomography (CT)-guided microcoil localization for pulmonary ground-glass opacity.Methods We performed CT-guided Microcoil localization in 30 patients with 32 pure ground glass opacities between December 2012 and September 2013.All 30 patients underwent CT-guided micmcoil localization under local anesthesia with a 21G needle percutaneous lung biopsy.All patients accepted video-assisted thoracic surgery after the localization the same day or the next day.Results We located 32 pure ground glass opacitiesin 30 patients.The mean lesion diameter was 0.94 cm,the average depth from the visceral pleura was 0.71 cm,all leisons were successfully located by microcoil,asymptomatic pneumothorax was observed in seven patients,pulmonary hematoma was observed in two patients,pain was observed in one patient,dislodgement was found in one patient during the operation.None of these cases needed surgical treatment.Pathologic diagnoses of the target leisions were as follows:adenocarcinoma in situ (n =17),adenocarcinoma(n =9),atypical hyperplasia(n =4),inflammation (n =2).After the placement of preoperative CT-guided microcoil localization for pulmonary ground-glass opacity,all the 32 pulmonary pure ground-glass opacities resection success rate was 100％.Conclusion Preoperative CT-guided microcoil localization for pulmonary pure ground-glass opacity is a safe and effective way to improve the accuracy of surgical resection.

Objective To analyze the investigation results of an acute respiratory infection outbreak caused by adenovirus and provide scientific information for the prevention and control of congener public health emergencies .Methods A case‐control study was performed with grades and gender as matching factor ,all cases and selected controls were investigated with the same question‐naire .Results A totul of 47 cases were diagnosed in the outbreak ,no death ,the attack rate was 8 .88% ;the main clinical symptom was fever and 27 .7% of the cases became pneumonia .The case‐control study analysis demonstrated that with close contact to cases or not(χ2 =7 .96 ,P<0 .05) ,contact time (χ2 =7 .95 ,P<0 .05) ,hand washing habits (χ2 =25 .92 ,P<0 .05) and with or without the habit of cleaning snivel by hand directly (χ2 =22 .78 ,P<0 .05) were statistically different between cases and controls .Conclu‐sion long‐time contact to cases maybe the main risk factor for the adenovirus infection ,especially the contact manner were sharing the same desk or playing together .A good health habit of washing hands often and no cleaning snivel by hand directly were impor‐tant protective factors .Thus ,strengthening the training of health habit and awareness is the important preventive measure for re‐spiratory infectious diseases .

OBJECTIVE To evaluate the use of antibiotics after coronary artery bypass.METHODS Forty patients were assigned into two groups,vancomycin group and cefradine group.Each included 20 patients.We compared the infection cases,cost of hospitalization,and cost of medicine after CABG.RESULTS There were no difference of(infection) between two groups,the cost of hospitalization was fewer in cefradine group.(CONCLUSIONS) The short-term use of cefradine after CABG could achieve the goals of preventing infection of CABG,and save medical resources.

AIM: To investigate the effect of inhibiting myosin light chain kinase ( MLCK) on endothelin-1 (ET-1) induced proliferation and apoptosis of rat pulmonary artery smooth muscle cells (PASMCs).METHODS: Rat PASMCs were cultured and stimulated with ET-1.The cells were randomly divided into control group , ET-1 group and ET-1+MLCK inhibitor group (ET-1+M).Western blotting, MTT assay, [3H]-TdR incorporation and flow cytometry were employed to test the expression of myosin light chain (MLC) and MLCK, cell proliferation, cell cycle and apoptotic rate of PASMCs ,respectively .The phosphorylation of MLC was determined by glycerol-PAGE coupled with Western blotting .RE-SULTS:Compared with control group , the protein expression of MLCK and MLC phosphorylation significantly enhanced af -ter ET-1 stimulation.ET-1 markedly induced the proliferation and decreased the percentage of apoptotic rate in the PASMCs.However, pretreatment with ML-7, a MLCK inhibitor, significantly reversed the above effects induced by ET-1. CONCLUSION:MLCK inhibitor effectively inhibits the ET-1-induced proliferation and the cell cycle progression .